Finally, practical and evidence-based suggestions for the evaluation and treatment of primary and secondary psychotic disorders are presented. The revised diagnostic criteria for secondary psychoses (those due to neurologic or medical conditions, substance use, and medications) also are reviewed briefly and the psychoses associated with common neurologic conditions tabulated. ![]() The criteria for psychotic disorders included in the DSM-5, 5 which have been revised substantially relative to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision ( DSM-IV-TR), 6 are a major focus of this review. This article also defines psychosis and reviews the essential clinical features of primary psychotic disorders and psychoses secondary to neurologic conditions. 1–4 Psychosis is, therefore, an important target of evaluation and treatment among patients receiving care from neurologists and psychiatrists. Across these conditions, psychosis is both a contributor to disability and a barrier to productivity and participation. Psychosis is the defining feature of schizophrenia spectrum disorders, a common but variable feature of mood and substance use disorders, and a relatively common feature of many developmental, acquired, and degenerative neurologic and medical conditions. Practical guidance on the evaluation and treatment of these conditions is drawn from practice guidelines promulgated by the professional societies and other international organizations, supplemented with findings published in more recent meta-analyses and systematic reviews. The current classification, updated criteria, and approaches to the evaluation of schizophrenia spectrum and related psychotic disorders, as well as psychoses in neurologic conditions, are reviewed. The definitions of psychosis used in the DSM-5 and International Classification of Diseases, Tenth Revision ( ICD-10) are presented, and hallucinations, delusions, and delusional misidentification syndromes are defined and tabulated. This article defines psychosis, communicates recent changes to the classification of and criteria for primary psychotic disorders described in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition ( DSM-5), and summarizes current evidence-based approaches to the evaluation and management of primary and secondary psychoses. ![]() ![]() Psychosis is a common and functionally disruptive symptom of many psychiatric, neurodevelopmental, neurologic, and medical conditions and an important target of evaluation and treatment in neurologic and psychiatric practice.
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