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Be Well, Think Well: Overview of Psychotic Disorders

You may have heard the word “psychotic” used to describe people.
Psychotic disorders cause a lot of problems in people’s everyday lives.
People with psychotic disorders lose touch with reality.
This means they often do not know what is real and what is not real.

What are psychotic disorders?

Psychotic disorders are severe mental disorders that cause problems with thinking. Psychotic disorders change the way a person views reality. Each type of psychotic disorder can have different problems. The most common problems are called delusions and hallucinations.


There are many types of delusions. A delusion is when a person cannot tell what is real and what is not real. People with psychotic disorders strongly believe things that are just not possible. Common delusions are beliefs that the person is someone else – like a celebrity or a religious figure. Another type of delusion that is common is the belief that people are “out to get” the individual. For example, they may believe that strangers are government operatives spying on them.


There are also many types of hallucinations. A hallucination is when someone experiences something that is not really there. This includes hearing sounds or voices, seeing things that are not there, smelling things, or feeling something on the person’s skin or body that is not there. A person with a psychotic disorder thinks these hallucinations are real. Convincing them that the hallucinations are not real is very difficult, if not impossible.

Thought Problems

A person with a psychotic disorder has trouble thinking clearly and making decisions. Also, their unclear thoughts may make communicating very difficult and frustrating. It may be so difficult that other people may not be able to understand what they are saying or what they are thinking.

Who can diagnose psychotic disorders?

Many health professionals can diagnose psychosis. These include psychiatrists, psychologists, clinical social workers, primary care physicians, nurse practitioners, and physician assistants. Some individuals with autism have thoughts and behaviors much the same as those seen in psychosis, making it important to work with a professional familiar with autism.

What is the DSM-5?

Mental health professionals use the Diagnostic and Statistical Manual, 5th Edition (DSM-5) to diagnose mental health conditions. Each condition has specific criteria that must be met to give someone a diagnosis.

The Clinical Interview

A clinical interview is one tool a mental health professional can use to diagnose psychosis. A clinical interview is a detailed conversation with patients and/or family members. A mental health professional reviews the person’s history, mental and physical health concerns, and mood symptoms. The doctor will ask if there are any big changes in behavior, appetite, or sleep. The clinician will ask about any unusual thoughts, beliefs, or fears. They will ask if the person hears or sees things that others cannot. The clinician will consider how the person’s symptoms and concerns match with symptoms of psychosis. The clinical interview will also help figure out what may be symptoms of autism and what may be symptoms of psychosis.

Input from family, friends & support staff

It is often hard for people to recognize and describe their moods, emotions, and behaviors accurately. For a person with autism it can be even more difficult. Because of this, the mental health professional may ask for input from those who know the individual well.

Screening Tools

A mental health professional might use specific tools to assess for psychosis. These screening tools are called ‘rating scales’. Rating scales do not diagnose a mental health problem. Rating scales can only tell the mental health professional how likely it is the symptoms are due to psychosis. Rating scales may be filled out either by the individual, a family member, or support staff. These rating scales are used along with the clinical interview and other information to develop a diagnosis.

Medical Tests

Doctors might also order medical tests, such as blood tests or scans. These medical tests can help the doctor rule out a physical or medical reason for symptoms of psychosis. If the symptoms are for medical reasons, doctors will follow up with a medical treatment. If the symptoms of psychosis are due to mental health reasons, a mental health professional will work with the person to develop an appropriate treatment plan.

Recognizing psychotic disorders

Psychotic disorders are some of the most intense mental health diagnoses that exist. It can be hard to recognize them, however, as they often share features with other mental illnesses. This section will help you identify when a person had a psychotic disorder.

Shared features

Psychotic disorders share some symptoms with other common mental illnesses including: disturbed sleep, high levels of anxiety, social withdrawal, suicidal thoughts or actions, and difficulty concentrating. What separates psychotic disorders from depression and anxiety disorders are the issues with understanding reality and abnormal thought processes.

Disorganized speech

Someone with a psychotic disorder will often be difficult to have a conversation with. They may jump rapidly from topic to topic, have a hard time sharing their thoughts, or just may not make much sense. They may be sharing bizarre and probably impossible thoughts and ideas, a common symptom of psychotic disorders.


Paranoid thinking is common in psychotic disorders. The individual with a psychotic disorder may confuse you with someone else, accuse you of something you’ve never done, accuse you of plotting against them, or accuse you of being a government operative attempting to cause them some type of harm.

Misunderstanding reality

Individuals with psychotic disorder typically struggle with understanding what’s real and what isn’t. They will often see and hear things that nobody else does and believe that they are really in the room with them. They may appear as though they’re talking to themselves, however, they are actually responding to someone they are seeing in the room or responding to a voice in their head that they believe is someone speaking to them. Also, they may experience physical sensations that are not real. This may include things like feeling as if bugs are biting them, resulting in them scratching to get them off despite there not being bugs on them.

Psychotic disorders have a big impact on how people live their lives. It can lead to them not taking care of themselves very well. Risks of having a psychotic disorder also include homelessness, being admitted to a psychiatric hospital, or even prison.

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Other downloads

Name Description Type File
Diagnosing Psychotic Disorders This resource reviews how mental health professionals diagnose psychotic disorders. pdf Download file: Diagnosing Psychotic Disorders
Recognizing Psychotic Disorders This resource will help you identify when a person had a psychotic disorder. pdf Download file: Recognizing Psychotic Disorders
What are Psychotic Disorders This resource will help you better understand the symptoms of a psychotic disorder. pdf Download file: What are Psychotic Disorders

This information was developed by the Autism Services, Education, Resources, and Training Collaborative (ASERT). For more information, please contact ASERT at 877-231-4244 or info@PAautism.org. ASERT is funded by the Bureau of Supports for Autism and Special Populations, PA Department of Human Services.