The Psychoses (was Re: ...muck...)

Doug Henwood dhenwood at panix.com
Mon Feb 7 10:20:58 PST 2000


Miles Jackson wrote:


>Just a note on this: nobody has "psychoses" anymore. It's not in the
>DSM-IV

No, but there's a whole section in DSM-IV (i.e., the fourth edition of the American Psychiatric Association's Diagnostic and Statistical Manual) on "psychotic disorders." Are we splitting hairs over the difference between "psychoses" and "psychotic disorders"?

Doug

[chapter intro from DSM-IV]


>Schizophrenia and Other Psychotic Disorders
>
>The disorders included in this section are all characterized by
>having psychotic symptoms as the defining feature. Other disorders
>that may present with psychotic symptoms (but not as defining
>features) are included elsewhere in the manual (e.g., Dementia of
>the Alzheimer's Type and Substance-Induced Delirium in the
>"Delirium, Dementia, and Amnestic and Other Cognitive Disorders"
>section; Major Depressive Disorder, With Psychotic Features, in the
>"Mood Disorders" section).
>
>The term psychotic has historically received a number of different
>definitions, none of which has achieved universal acceptance. The
>narrowest definition of psychotic is restricted to delusions or
>prominent hallucinations, with the hallucinations occurring in the
>absence of insight into their pathological nature. A slightly less
>restrictive definition would also include prominent hallucinations
>that the individual realizes are hallucinatory experiences. Broader
>still is a definition that also includes other positive symptoms of
>Schizophrenia (i.e., disorganized speech, grossly disorganized or
>catatonic behavior). Unlike these definitions based on symptoms, the
>definition used in earlier classifications (e.g., DSM-11 and ICD-9)
>was probably far too inclusive and focused on the severity of
>functional impairment, so that a mental disorder was termed
>"psychotic" if it resulted in "impairment that grossly interferes
>with the capacity to meet ordinary demands of life." Finally, the
>term has been defined conceptually as a loss of ego boundaries or a
>gross impairment in reality testing. The different disorders in this
>section emphasize different aspects of the various definitions of
>psychotic. In Schizophrenia, Schizophreniform Disorder,
>Schizoaffective Disorder, and Brief Psychotic Disorder, the term
>psycbotic refers to delusions, any prominent hallucinations,
>disorganized speech, or disorganized or catatonic behavior. In
>Psychotic Disorder Due to a General Medical Condition and in
>Substance-induced Psychotic Disorder, psychotic refers to delusions
>or only those hallucinations that are not accompanied by insight.
>Finally, in Delusional Disorder and Shared Psychotic Disorder,
>psychotic is equivalent to delusional.



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