Core concepts
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Diagnostic uncertainty means that available information does not yet support a confident or specific diagnosis. It is common early in psychosis because several conditions initially look similar. The relationship between mood and psychosis may become…Continue Reading

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Differential diagnosis is the process of comparing plausible explanations for a person’s symptoms. Psychosis can occur in schizophrenia, schizoaffective disorder, bipolar disorder, severe depression and substance-related conditions. Neurological illness, delirium and some other medical disorders…Continue Reading

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Medical investigations help identify conditions that can cause or worsen psychotic symptoms and establish a baseline for treatment. The choice depends on the history and examination. Clinicians may request blood tests, a physical examination or…Continue Reading

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A psychiatric assessment is a structured conversation and examination aimed at understanding mental health difficulties. For suspected psychosis, it explores perceptions, beliefs, mood, thinking, sleep and changes in behaviour. The clinician asks when experiences began…Continue Reading

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Diagnostic criteria are agreed rules for identifying a condition consistently. For schizophrenia, they describe characteristic symptoms, their duration, changes in functioning and the exclusion of other explanations. Hallucinations, delusions and disorganised speech are important features…Continue Reading

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The depressive type of schizoaffective disorder involves major depressive episodes alongside the required pattern of psychotic symptoms, without a history of mania. Depression may affect mood, interest, appetite, sleep, self-worth and the ability to think…Continue Reading

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The bipolar type of schizoaffective disorder includes manic episodes within an illness that also meets the relevant psychosis criteria. Depressive episodes may occur, but a history of mania is the defining mood feature. During mania…Continue Reading

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A mood episode is a sustained period of clinically significant changes in emotion, energy and associated functioning. In schizoaffective disorder, this may involve a major depressive episode or a manic episode. Depression can include persistent…Continue Reading

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Psychotic symptoms in schizoaffective disorder can include hallucinations, delusions and disorganised thinking. Someone may hear voices, interpret neutral events as personally directed messages or struggle to express a coherent train of thought. These experiences can…Continue Reading