Centre for Addiction
and Mental Health

First Episode Psychosis: An Information Guide

The Different Types of Psychosis

First Episode Psychosis: An Information Guide

There are a number of mental illnesses that can include psychosis as a symptom. In the early phases of a psychotic episode, it is usually difficult to diagnose the exact type of psychosis that is happening. This is because the factors that determine a specific diagnosis are often unclear during the psychotic episode. It is important to recognize and understand symptoms, and to communicate them to the treatment team. Any concerns or questions about diagnosis should be discussed with a mental health professional.

The following list provides the names and brief descriptions of different types of psychotic illness.

Schizophrenia
The term schizophrenia refers to a type of psychosis in which a person experiences some psychotic symptoms for at least six months, with a significant decline in the person’s ability to function. The symptoms and length of the illness vary from person to person.

Schizophreniform disorder
This type of psychosis is the same as schizophrenia except that the symptoms have lasted for less than six months. The illness may completely resolve or may persist and progress to other psychiatric diagnoses, such as schizophrenia, bipolar disorder or schizoaffective disorder.

Bipolar illness
With this type of illness the symptoms of psychosis relate more to mood disturbance than to thought disturbance. A person will experience mood elevations (mania) and sometimes depression, which may persist or fluctuate in intensity. When psychotic symptoms arise, they often reflect the person’s mood. For example, people who are depressed may hear voices that put them down. People who are experiencing an elevated mood may believe they are special and are capable of doing amazing things.

Schizoaffective disorder
During this type of psychosis, a person will experience symptoms of schizophrenia and symptoms of a mood disturbance, either at the same time or alternating over time.

Depression with psychotic features
Sometimes a person will experience a severe depression with symptoms of psychosis without the mania associated with bipolar disorder. This type of depression is referred to as a psychotic depression or depression with psychotic features.

Drug-induced psychosis
The use of drugs such as marijuana, cocaine, LSD, amphetamines and alcohol can sometimes cause psychotic symptoms to appear. Once the effects of the drugs or alcohol wear off, the symptoms of psychosis will usually resolve. However, the symptoms themselves may require medical treatment.

Organic psychosis
Symptoms of psychosis may appear as a result of a physical illness or a head injury. A thorough medical examination should be conducted to rule out or confirm this type of psychosis. This examination may involve some tests or investigations such as a brain scan.

Brief psychotic disorder
Sometimes symptoms of psychosis come on suddenly and, in some cases, are triggered in response to a major stress in the person’s life, such as a death in the family. This type of psychosis usually lasts less than a month.

Delusional disorder
This type of psychosis consists of very strong and fixed beliefs in things that are not true. Changes in perception, such as hallucinations, are not seen in this illness. A delusional disorder does not usually affect a person’s ability to function.

It may be difficult to make a diagnosis in the early stages. Therefore it may not be helpful to focus on a particular diagnosis. It is also important to remember that everyone’s experience of psychosis is different. Course and outcome will vary from person to person.