Other schizophrenia spectrum and psychotic disorders

[Tariq Zaki]

Some significant episodes of psychotic symptoms do not fulfill criteria for other diagnoses in the schizophrenia spectrum.
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.
Other psychotic disorders are categorized as

Other specified schizophrenia spectrum and other psychotic disorders
Unspecified schizophrenia spectrum and other psychotic disorders

These categories refer to symptoms that are typical of a schizophrenia spectrum or other psychotic disorder (eg, delusions, hallucinations, disorganized thinking and speech, catatonic behavior), that cause substantial social and occupational distress and impairment, but that do not meet the full criteria for any specific disorder. These categories sometimes apply early in a schizophrenia spectrum disorder before it has fully manifested.
The category psychotic disorder not otherwise specified is no longer used.
A disorder is classified as specified if the clinician chooses to specify how the characteristics of the symptoms do not meet the criteria for a specific disorder. For example, a patient may have persistent auditory hallucinations with no other symptoms, thus not meeting criteria for schizophrenia, which requires 2 psychotic manifestations.
The unspecified category is used when the information needed to make a diagnosis is insufficient (eg, in an emergency department).
Antipsychotic drugs and psychiatric referral may be used as needed.
(See also Introduction to Schizophrenia and Related Disorders.)