Presenting Complaints

• Patients may experience:

• Hearing voices
• Strange beliefs or fears
• Confusion

• Families may ask for help with changes in behaviour that cannot be explained including strange or frightening behaviour (e.g. withdrawal, suspiciousness, threatening behaviour.)

Diagnostic Features

• Recent onset of:
  
  
  • Hallucinations - False or imagined sensations (e.g. hearing voices when no-one is around).
    
    
  • Delusions - Firmly held ideas which are plainly false and not shared by others in the patients social group (e.g. patient believes he/she is being poisoned by neighbors, receiving messages from TV, or is looked at by others some special way).
    
    
  • Disordered thinking - exhibited by strange or disjointed speech
    

Differential Diagnosis

• Physical disorders which can cause psychotic symptoms include:
  • Epilepsy
  • Intoxication or withdrawal from drugs or alcohol
  • See section on Delirium.
    
    
• If psychotic symptoms are recurrent or chronic, see section on Chronic Psychotic Disorders .
  
  
• If symptoms of mania (elevated mood, racing speech or thoughts, exaggerated self-worth) are prominent, patient may be experiencing a manic episode. See section on Bipolar Disorder .
  
  
• If low or sad mood is prominent, see section on Depression .