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You are here : > Health Centers > Mental Health - DepressionSchizophrenia • • Schizophrenia Diagnosis

Misdiagnosis, or other disorders that may look like schizophrenia

Schizophrenia • • Schizophrenia DiagnosisMay 11, 2009

It is crucial to realize that schizophrenia is not the cause of all psychotic symptoms. Psychosis is a general term used to describe psychotic symptoms whereas schizophrenia is a type of psychosis. In addition to schizophrenia, psychotic symptoms may result from a variety of causes, including brain trauma, strokes, tumors,  infections,  or the use of illegal drugs.  Misdiagnosis is common in schizophrenia for precisely this reason. Mental health professionals may require several months (or years) in order to determine that the cause of psychotic symptoms is schizophrenia and not some other condition.

Indeed, assessing a patient with psychotic symptoms can be a challenging task. Clinicians and researchers typically go through a process of “ruling out” other disorders before confirming a diagnosis. In addition to brain trauma, there are other mental disorders in which symptoms appear very similar to those of schizophrenia. Sometimes there are more appropriate diagnoses for individuals with psychotic symptoms.

For example, some patients with psychotic symptoms also have depression. When this is the case, a clinician must consider a diagnosis of schizoaffective disorder. Alternatively, the use of some illegal drugs may mimic psychotic symptoms.  In order to determine that the symptoms are truly those of schizophrenia, it is important to determine that the patient has not been using substances that can cause these behaviors. Some other disorders in which psychotic symptoms are prominent follow.

Schizoaffective Disorder. Schizoaffective disorder is characterized by both schizophrenia and severe mood disorder symptoms. Someone with schizoaffective disorder meets diagnostic criteria for schizophrenia and at the same time experiences severe moods and marked changes of mood.

Schizophreniform Disorder. In order to receive a diagnosis of schizophrenia, one must exhibit psychotic symptoms for at least six months. Alternatively, a diagnosis of schizophreni-form disorder is used when patients have only experienced these symptoms between one and six months. Presumably, every schizophrenia patient was a candidate for a diagnosis of schizophreniform disorder, as it is basically the same thing as schizophrenia, only for a shorter period of time.

Delusional Disorder. People with delusional disorder endorse beliefs that are have no grounding in reality. Contrary to schizophrenia, however, delusional disorder is not marked by extreme behavior change or disorganized behavior. Patients with delusional disorder can function normally, except for their behaviors brought about by their delusions. An example of a common form of delusion seen in delusional disorder is erotomania.

Patients with erotomania believe that they are involved in a love affair with someone, even if this is not true. It is not uncommon for people with erotomania to believe they are having a relationship with a movie star or a famous politician.

Brief Psychotic Disorder. Brief psychotic disorder involves the sudden development of psychotic symptoms and rarely lasts for more than a few days. Typically, these episodes are brought about by an extremely stressful event,  such as the death or infidelity of a spouse or the loss of a job. After the psychotic symptoms remit, they rarely return and the person returns to normal. Brief psychotic disorder is very rare and not often seen in clinical settings.

Shared Psychotic Disorder.  Called folie a deux in French, shared psychotic disorder is perhaps the most puzzling of all these categories. Translated, folie a deux means “madness shared by two” and occurs when one person (let’s call this person A) has a close relationship with someone who has a delusion (person B). Over time, person A begins to believe in person B’s delusion and ultimately the two share the same delusion.

Drug-Induced Psychosis. Because the effects of some illegal drugs mimic psychotic symptoms, it is necessary to determine that a patient who is experiencing symptoms is not using drugs. Some drugs that can cause schizophrenia-like symptoms include cocaine, methamphetamine, and hallucinogens.


Provided by ArmMed Media

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I was diagnosied with schizoaffective, until I found out that I didn’t have the symptoms when I didn’t drink caffine. After haveing a new found cognition, I quickly realized my Doc was a moron.. spent a few months until being able to see a new doctor.. after 4 months schizoaffective was ruled a misdiagnosis. Drinking sodas was almost like an instant switch between depression and delusion and real life. From my experience, caffeine should also be listed with the drug induced psychosis… Just try no caffeine.. I went from 235 lbs, way overweight, either sleep all day or didn’t sleep at all, depressed and delusional.. to now 160 lbs, rather fit, and working, no meds at all, a great perspective on life, and sweet motiviation. All because that by a god-chance, I didn’t have any caffeine or meds for 3 weeks, and it was just too odd that my schizoaffective symptoms completely disapeared during that time.

posted by Mesa on 08/16/2010 at 6:18 pm -08:00

“Brief psychotic disorder is very rare and not often seen in clinical settings.” ???????

40% Prevalance (lifetime) rating of Brief Reactive Psychosis exists among ALL patients with ANY psychotic disorder—this is MORE common than Schizophrenia.

4 in 10 patients who have a psychotic episode of any kind, according to peer-reviewed Medscape, have brief reactive psychosis that never converts to any other psychosis.

posted by F. Kauffman on 05/11/2014 at 2:03 pm -08:00

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