Psychiatric Differential Diagnosis of Psychosis

Part of the Current Clinical Psychiatry book series (CCPSY)


Primary psychotic disorders include a wide variety of psychiatric disorders, including but not limited to schizophrenia spectrum disorders. In this chapter, I describe the clinical characteristics of psychiatric disorders where psychosis is an obligatory part of the symptom picture (i.e., schizophrenia spectrum disorders) or where psychosis is merely an ancillary but not core feature (i.e., psychotic mood disorder). Included in this chapter is catatonia because its recognition is important for treatment.


Schizophrenia spectrum disorders Differential diagnosis Schizoaffective disorder Schizotypal disorder Schizoid personality disorder Delusional disorder Atypical psychosis Cycloid psychoses Acute and transient psychotic disorders (ATPD) Psychotic mood disorders Psychotic depression Psychotic mania Folie a deux Catatonia Obsessive-compulsive disorder Autism 


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Additional Resources


    1. McKenna P. Delusions: understanding the un-understandable. Cambridge: Cambridge University Press; 2017. – Our current understanding of the un-understandable (a criterion for delusions, “Unverstehbarkeit,” according to Karl Jaspers). This book includes a section on delusional disorder.Google Scholar


    1. Gerevich J, Ungvari GS. The description of the litigious querulant: Heinrich von Kleist’s Novella Michael Kohlhaas. Psychopathology. 2015;48:79–83. – If you find the time, get the short book by the German romantic writer (available in English) and read his classic case study about how an injustice becomes an all-consuming quest for justice, resulting in catastrophe. You may recognize in Kohlhaas patients in your treatment system whose life mission is litigation to rectify a wrong. While the term querulant paranoia is sometimes employed, some patients may be better described by having overvalued ideas.Google Scholar
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Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  1. 1.Department of PsychiatryMassachusetts General HospitalBostonUSA

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