Catatonia can occur in several disorders, including neurodevelopmental, psychotic, bi— polar, depressive, and other mental disorders. This chapter also includes the diagnoses catatonia associated with another mental disorder (catatonia specifier), catatonic disorder due to another medical condition, and unspecified catatonia, and the diagnostic criteria for all three conditions are described together.
ders are included for classifying psychotic presentations that do not meet the criteria for any of the specific psychotic disorders, or psychotic symptomatology about which there is inadequate or contradictory information.
Clinician—Rated Assessment of Symptoms and
Psychotic disorders are heterogeneous, and the severity of symptoms can predict impor- tant aspects of the illness, such as the degree of cognitive or neurobiological deficits. To move the field forward, a detailed framework for the assessment of severity is included in
Section III "Assessment Measures," which may help with treatment planning, prognostic decision making, and research on pathophysiological mechanisms. Section III ”Assess- ment Measures” also contains dimensional assessments of the primary symptoms of psy- chosis, including hallucinations, delusions, disorganized speech (except for substance/ medication-induced psychotic disorder and psychotic disorder due to another medical condition), abnormal psychomotor behavior, and negative symptoms, as well as dimen— sional assessments of depression and mania. The severity of mood symptoms in psychosis has prognostic value and guides treatment. There is growing evidence that schizoaffective disorder is not a distinct nosological category. Thus, dimensional assessments of depres- sion and mania for all psychotic disorders alert clinicians to mood pathology and the need to treat where appropriate. The Section III scale also includes a dimensional assessment of cognitive impairment. Many individuals with psychotic disorders have impairments in a range of cognitive domains that predict functional status. Clinical neuropsychological as- sessment can help guide diagnosis and treatment, but brief assessments without formal diagnostic purposes. Formal neuropsychological testing, when conducted, should be ad- ministered and scored by personnel trained in the use of testing instruments. If a formal neuropsychological assessment is not conducted, the clinician should use the best avail- able information to make a judgment. Further research on these assessments is necessary in order to determine their clinical utility; thus, the assessments available in Section 111 should serve as a prototype to stimulate such research.
Criteria and text for schizotypal personality disorder can be found in the chapter "Person- ality Disorders.” Because this disorder is considered part of the schizophrenia spectrum of disorders, and is labeled in this section of ICD-9 and ICD-10 as schizotypal disorder, it is listed in this chapter and discussed in detail in the DSM-5 chapter ”Personality Disorders."
Diagnostic Criteria 297.1 (F22)
A. The presence of one (or more) delusions with a duration of 1 month or longer.
B. Criterion A for schizophrenia has never been met.
Note: Hallucinations, if present, are not prominent and are related to the delusional theme (e.g., the sensation of being infested with insects associated with delusions of infestation).
C. Apart from the impact of the delusion(s) or its ramifications, functioning is not markedly impaired, and behavior is not obviously bizarre or odd.
D. It manic or major depressive episodes have occurred, these have been brief relative to the duration of the delusional periods.
E. The disturbance is not attributable to the physiological effects of a substance or an- other medical condition and is not better explained by another mental disorder, such as body dysmorphic disorder or obsessive-compulsive disorder.
Specify whether:
Erotomanlc type: This subtype applies when the central theme of the delusion is that another person is in love with the individual.
Grandiose type: This subtype applies when the central theme of the delusion is the conviction of having some great (but unrecognized) talent or insight or having made some important discovery.