DSM-IV

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Schizoaffective Disorder
Exhibit 2 or more symptoms during a month
 Delusions*
 Hallucinations*
 Incoherent, derailed, and disorganized
speech
 Severely disorganized or catatonic behavior
 Symptoms of depression or Manic episodes

Delusional Disorder
Criterion A for Schizophrenia never met
 Nonbizarre delusions for at least 1 month
 Functioning not obviously impaired
 If mood disturbances occur, their total
duration is brief relative to the duration of
the delusional symptoms
 Not due to substance or GMC

Delusional D/O vs.
Schizophrenia
Later age of onset
 Associated with family traits (including
suspiciousness, jealousy, and secretiveness)
as opposed to history of psychotic sxs.
 Frequently re-diagnosed as Schizophrenia
 Hallucinations are present, but rare

Brief Psychotic Disorder
Psychotic for at least a day and then return
to baseline
 At least one symptom (delusions,
hallucinations, disorganized speech
 Not due to mood disorder, Schizophrenia or
Schizoaffective Disorder

Shared Psychotic Disorder
Someone closely associated with a
delusional person also develops a delusion
 Content of delusion similar to that of the 1st
person’s delusion
 Not explained by other Psychotic disorders
or GMC

Psychotic Disorder NOS
Charles Bonnet syndrome
 Postpartum psychosis
 Auditory hallucinations

Dissociative Amnesia
• One or more episodes of an inability
to recall important personal
information that cannot be
attributed to ordinary forgetfulness.
• Usually related to gaps in memories
related to traumatic events
• A chronic, yet reversible amnesia
Dissociative Fugue
• Abrupt, unexpected travel away from
home or work with an inability to recall
some or all of one’s past.
• Individuals exhibit confusion about his/her
personal identity or a partial or total
assumption of new identity.
• May seem “normal” during the fugue, but
following recovery, the person may not
recall events that took place during the
fugue
• Very rare and occurs most during wartime
or following a natural disaster
Dissociative Identity Disorder*
• Existence in one individual of two or more
distinct identities or personality states that
each has its own pattern of perceiving,
relating to, and thinking about the
environment and self.
• At least 2 of the personalities take control
of the person’s behavior in sequence, with
gaps in recent & past memories for
personal information.
• Personalities are typically unique and
change abruptly occasionally triggered by
stress or external cues.
Depersonalization
Disorder
• One or more episodes of
depersonalization, which
involves a feeling of
detachment or estrangement
from oneself.
• Reality testing is intact
• Symptoms are severe enough to
cause significant distress or
functional impairment
Dissociative Disorders NOS
• Derealization without
depersonalization
• Brainwashing
• Coma/Loss of consciousness
• Ganser’s Syndrome
• Dissociative Trance Disorder
Impulse Disorders
Intermittent Explosive
Disorder
• Several occasions of losing
control of aggressive impulses,
leading to serious assault or
property destruction
• Aggression is markedly out of
proportion to the seriousness of
any social or psychological
stressors
• Not due to PDO or GMC
Kleptomania
• A repeated pattern of an
irresistible impulse to steal
unneeded objects.
• Produces a buildup of tension and
“release” once action is performed
• Thefts are not committed out of
anger, revenge, or in response to
hallucination or delusions
• Not better explained by APDO,
Conduct DO or Manic Episode
Pyromania
• A repeated and irresistible urge
to set or be attracted to fires
• Produces a buildup of tension
and “release” once action is
performed
• Not better explained by APDO,
Conduct D/O, or Manic Episode
Trichotillomania
• Recurrent failure to resist
pulling out one’s own hair.
• Produces a buildup of tension
and “release” once action is
performed
Pathological Gambling
• Repeated gambling (and
associated activities) usually to
the point of losing money, job,
and friends.
• Produces buildup of tension and
“release” once action is
performed
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