Abstract
Descriptive psychopathology which includes phenomenology provides language to describe a patient’s behavior and inner experiences. This chapter reviews the main symptoms of psychosis (delusions, hallucinations, disorganized thinking), with emphasis on how to detect them. Recognizing Schneiderian first-rank symptoms which are evidence of psychosis remains an important clinical skill for psychiatrists even though these symptoms are de-emphasized in current classification systems. Overvalued ideas are introduced as not all extreme views are psychotic. Last, disorganized behaviors and unusual motor phenomena (catatonia) are described as those often occur in psychotic patients.
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Additional Resources
Websites
https://www.hearing-voices.org/. Hearing Voices Network (HVN) is an alliance of support groups that operates worldwide and provides an alternative, non-medicalized view of hallucinations. It represents an effort by the peer movement to destigmatize hearing voices and avoid aggressive, unhelpful psychiatric treatment. I consider them an important, alternative voice, hopefully collaborative and not in opposition to mainstream care, even if I do not agree with all their assumptions.
Books
Oyebode F. Sims’ symptoms in the mind: textbook of descriptive psychopathology. 6th ed: Elsevier; 2018. The standard (English) text since its first edition in 1988 about everything you ever wanted to know about descriptive psychopathology, written in clear language.
Enoch MD, Ball HN. Uncommon psychiatric syndromes. 4th ed. London: Arnold; 2001. Detailed account of 11 more unusual, mostly eponymous psychiatric syndromes like Capgras. A book that used to be in the psychiatric canon.
Sacks O. Hallucinations. New York: Vintage Books; 2013. A brilliant book by the late neurologist and medical writer about the varied facets of hallucinations.
Article
Berrios GE, Dening TR. Pseudohallucinations: a conceptual history. Psychol Med. 1996;26:753–63. An excellent discussion about the conceptual history of pseudohallucinations and its problems.
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Freudenreich, O. (2020). Psychotic Signs and Symptoms. In: Psychotic Disorders. Current Clinical Psychiatry. Humana, Cham. https://doi.org/10.1007/978-3-030-29450-2_1
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