Psychosis refers to symptoms such as delusions, hallucinations, disorganized thinking and speech, and bizarre and inappropriate motor behavior (including catatonia) that indicate loss of contact with reality. (See also Introduction to Schizophrenia and Related Disorders Introduction to Schizophrenia and Related Disorders Schizophrenia and related psychotic disorders—brief psychotic disorder, delusional disorder, schizoaffective disorder, schizophreniform disorder, and schizotypal personality disorder—are characterized... read more .)
At presentation, schizophrenia Schizophrenia Schizophrenia is characterized by psychosis (loss of contact with reality), hallucinations (false perceptions), delusions (false beliefs), disorganized speech and behavior, flattened affect... read more is likely to be suspected. Psychosis secondary to substance use Substance-/Medication-Induced Psychotic Disorder Substance- or medication-induced psychotic disorder is characterized by hallucinations and/or delusions due to the direct effects of a substance or withdrawal from a substance in the absence... read more or to a physical disorder must also be ruled out. Differentiating between schizophreniform disorder and schizophrenia Schizophrenia Schizophrenia is characterized by psychosis (loss of contact with reality), hallucinations (false perceptions), delusions (false beliefs), disorganized speech and behavior, flattened affect... read more in a patient without any prior psychotic symptoms is based on duration of symptoms. If duration of symptoms or disability exceeds 6 months, the patient no longer meets required diagnostic criteria for schizophreniform disorder, and the diagnosis is likely to be schizophrenia, although the acute psychosis may also evolve into a psychotic mood disorder, such as bipolar disorder Bipolar Disorders Bipolar disorders are characterized by episodes of mania and depression, which may alternate, although many patients have a predominance of one or the other. Exact cause is unknown, but heredity... read more or schizoaffective disorder Schizoaffective Disorder Schizoaffective disorder is characterized by psychosis, other symptoms of schizophrenia, and significant mood symptoms. It is differentiated from schizophrenia by occurrence of ≥ 1 episode of... read more . Longitudinal observation is often required to establish the diagnosis and appropriate treatment.
Treatment with antipsychotics Antipsychotic Drugs Antipsychotic drugs are divided into conventional antipsychotics and 2nd-generation antipsychotics (SGAs) based on their specific neurotransmitter receptor affinity and activity. SGAs may offer... read more and supportive psychosocial care is indicated. After symptoms resolve, drug treatment is continued for 12 months and then gradually tapered while closely monitoring for the return of psychotic symptoms.