Psychotic features, such as hallucinations and delusions, are symptoms present in some mental illnesses, including schizophrenia and depression. The presence of these features can complicate diagnosis and treatment, and antipsychotic drugs may be prescribed even if an individual does not have psychotic symptoms.
Psychotic features are symptoms that may be present in some mental illnesses. Such conditions, such as schizophrenia or delusional disorders, are diagnosed solely on the presence of these symptoms. In other cases, illnesses such as major depression or bipolar disorder may also have elements of psychosis, although not all people with these illnesses experience these additional symptoms. Generally, these features are hallucinations or delusions.
Hallucinations can be described as seeing, hearing, feeling, or experiencing things that aren’t there. Most commonly, people may experience auditory or visual hallucinations. Delusions are the belief in things that are not true. For example, a person might believe that aliens are trying to read her mind, or she might believe that a famous person is trying to contact them. Both hallucinations and delusions are psychotic features or the main symptoms of some types of mental illness.
When these features are present with no other symptoms, this can lead to the diagnosis of conditions such as schizophrenia, schizophreniform, brief psychotic disorder, or one of the delusional disorders. Matters are complicated when a person also has an overt mood disorder such as unipolar depression or bipolar illness. While not all people with depression or bipolar disorder have psychotic symptoms, some do. The diagnostician or mental health professional must account for these extra symptoms, as different types of medications may be more appropriate and a greater level of patient surveillance may be required.
In the Diagnostic and Statistical Manual® (DSM®) the additional phrase “with psychotic features” is an important part of an accurate diagnosis of bipolar and depressive illness. When practitioners notice that a patient is experiencing these extra symptoms, they also need to reflect and add an additional specifier as to whether these features are mood-congruent or mood-incongruent.
For example, a severely depressed person who feels psychotic levels of guilt has mood-congruent psychotic features. This means that guilt and depressed mood are combined. Conversely, a person with bipolar disorder who is having persecutory delusions suffers from mood incongruity in addition to her illness. There is little connection between persecution and mood swings.
The psychotic symptoms of an illness are often treated with a variety of antipsychotic drugs, which can be given in addition to mood-stabilizing drugs if a mood disorder is also present. It can take some time to find the right combination of medications, but many people respond well to treatment. It should be noted that some of the minor antipsychotic drugs such as quetiapine and aripiprazole are sometimes prescribed for mood disorders even if an individual does not suffer from psychotic symptoms.
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