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Psychotic Signs and Symptoms

  • Oliver Freudenreich
Chapter
Part of the Current Clinical Psychiatry book series (CCPSY)

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.

Keywords

Psychosis Descriptive psychopathology Delusions Overvalued ideas Hallucinations Pseudohallucinations Eponyms Schneiderian first-rank symptoms Self-disturbances Formal thought disorder Disorganization Disorganized behavior Catatonia 

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Additional Resources

    Websites

    1. 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

    1. 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.Google Scholar
    2. 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.Google Scholar
    3. Sacks O. Hallucinations. New York: Vintage Books; 2013. A brilliant book by the late neurologist and medical writer about the varied facets of hallucinations.Google Scholar

    Article

    1. 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.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Oliver Freudenreich
    • 1
  1. 1.Department of PsychiatryMassachusetts General HospitalBostonUSA

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