What are Psychotic Disorders?

Psychotic disorders are characterized by a disconnection from reality, often involving auditory or visual hallucinations, delusions, and persistent paranoid thoughts. Psychosis, a sudden departure from reality, can be triggered by factors such as brain injuries, viruses, extreme stress, or substance use. When no apparent underlying causes are present, a psychotic episode may be indicative of a psychotic disorder.

What causes Psychotic Disorders?

Psychosis does not have a single cause but is believed to result from a complex interplay of genetic factors, variations in brain development, and exposure to stressors or trauma. It can manifest as a symptom of mental disorders like schizophrenia, bipolar disorder, or severe depression, though a person may experience psychosis without being diagnosed with a specific disorder.

In older adults, psychosis symptoms may be linked to physical or mental illnesses that arise later in life, including Parkinson's disease, Alzheimer's disease, and related dementias. Other potential triggers for psychosis encompass sleep deprivation, specific medications, and substance misuse. Diagnosing a mental illness, like schizophrenia, typically involves ruling out these alternative causes.

Symptoms of Psychotic Disorders

Individuals dealing with psychosis often encounter delusions, characterized by false beliefs, such as thinking that individuals on television are sending them specific messages or that others are plotting harm against them. Additionally, hallucinations, where they may see or hear things not perceived by others, like voices instructing them or passing judgment, are common. Additional symptoms may involve incoherent or nonsensical speech, as well as behavior that is unsuitable for the given situation.

However, behavioral changes often manifest before psychosis develops. Behavioral warning signs include

  • Suspicion, paranoid thoughts, or discomfort with others
  • Trouble thinking clearly and logically
  • Increased social withdrawal and prolonged solitude
  • Unusual or overly intense ideas, strange emotions or lack of emotions
  • Decline in self-care or personal hygiene
  • Sleep disruptions such as difficulty falling asleep
  • Difficulty distinguishing reality from fantasy
  • Incoherent speech or difficulty communicating
  • Sudden drop in grades / job performance

Individuals affected by psychotic disorders may also experience more general behavioral changes including

  • Emotional disruption
  • Anxiety
  • Loss of motivation
  • Difficulty functioning overall

In certain instances, an individual undergoing a psychotic episode may exhibit unusual or unpredictable behaviors, posing a risk of self-harm or becoming threatening or violent towards others. The likelihood of violence and suicide diminishes with appropriate treatment for psychosis, underscoring the importance of seeking help. If you observe these behavioral changes in yourself or someone else, and they persist or escalate, it is crucial to contact a healthcare provider for assistance.

Types of Psychotic Disorders

Psychosis is a common symptom of many mental health conditions.


Schizophrenia is characterized by delusions, hallucinations, disorganized thoughts and speech, unusual behavior, and withdrawal.

Schizoaffective Disorder

Schizoaffective Disorder is defined as having symptoms of both schizophrenia and a mood disorder (such as depression or bipolar disorder).

Schizophreniform Disorder

Individuals with Schizophreniform Disorder present symptoms of schizophrenia that last longer than one month and for less than six months.

Brief Psychotic Disorder

A Brief Psychotic Disorder is defined by an episode of psychotic behavior that lasts for less than one month.

Delusional Disorder

Those with Delusional Disorder have false beliefs involving real-life situations. For example, a person with the disorder may falsely believe that someone is plotting against them or that a partner is being unfaithful.

Substance/medication-induced Psychotic Disorder

Certain drugs, including not only illicit drugs such as hallucinogens and stimulants but also prescribed medications such as steroids and antiepileptic drugs, can trigger short-term or long-term symptoms of psychosis.

Shared Psychotic Disorder

This is a rare disorder in which two or more people in a close relationship share a specific delusion. In such cases, a person without mental illness may start to believe the delusions of another person who has a psychotic disorder.

Diagnosing Psychotic Disorders

Serene Mental Health Clinic is your source for diagnosing Psychotic Disorders.

The diagnosis of Psychotic Disorders is based on a set of criteria that is used for each of these conditions. The criteria generally include a list of thoughts, behaviors, and duration of symptoms. Usually, diagnosis of a psychotic disorder requires that a person has a certain number or combination of the clinical criteria, not necessarily all of them.

An evaluation for a possible psychotic disorder will likely include

  • Review of a complete medical and psychiatric history
  • A neurological exam
  • Cognitive testing

Some of the symptoms of psychotic disorders occur due to other medical, neurological, and psychological conditions. If an individual's assessment does not meet the criteria for a psychotic disorder and/or there is concern that the individual might have another medical condition, further diagnostic testing may be required.

There are no blood tests or imaging tests that are considered indicative or that can confirm psychotic disorders. However, diagnostic tests may be used to rule out other potential causes of psychosis symptoms.

Treating Psychotic Disorders

The treatment for a Psychotic Disorder is tailored to the underlying condition and may involve a combination of prescription medication and psychotherapy (talk therapy). An individual may be prescribed one or more antipsychotic medications, and a medication for treating a mood disorder may also be recommended if applicable.

Psychothery helps individuals recognize and modify unhealthy emotions, thoughts, and behaviors. Medications utilized for treating psychotic disorders encompass typical antipsychotics and atypical antipsychotics. Both categories of medications can manage symptoms, and healthcare providers collaborate with individuals to determine the most suitable option for managing their condition.

The most common side effect of typical antipsychotic medications is sleepiness. Typical antipsychotics are associated with extrapyramidal side effects—tremors, spasms, muscle rigidity, and diminished control of movement. Side effects can diminish with medication adjustments, but sometimes extrapyramidal symptoms remain even after the medication is discontinued.

Atypical antipsychotics are not as likely to cause extrapyramidal side effects as typical antipsychotics. They can cause side effects, including constipation, sleepiness, weight gain, high cholesterol, and decreased sex drive.

Individuals may have episodes during which the effects of their psychotic condition worsen substantially, necessitating in-patient treatment. During this time, the individual will be kept safe, and their medication may be adjusted.