My daughter has changing diagnosis. She is 20 and had to leave college to return to enter an intensive day treatment program. She suffered from depression, anxiety, hallucinations and some cognitive changes where she could not read nor do school work. First she was diagnosis as Major Depression with psychosis, then schizophrenia, then they were ruling out PTSD and now they are saying Psychosis since the PTSD symptoms were from delusions.She is taking Geodon, Zoloft, Trihexyphenidyl and Temazepan…which are helping. What is the difference between schizophrenia and psychosis and why is it so difficult to get a diagnosis?

A. Psychosis is not a mental health disorder per se. People experience psychosis in the course of psychotic-based disorders such as schizophrenia. People may confuse psychosis with the diagnosis psychotic disorder not otherwise specified (NOS). Psychotic disorder NOS is a generalized disorder given to individuals who have experienced a psychotic episode but don’t meet any other criteria for other psychotic-based disorders such as schizophrenia. One cannot receive a diagnosis of psychosis but they could be diagnosed as having schizophrenia.

If someone experiences psychosis they have a break with reality. A psychotic episode (a phrase used interchangeably with psychosis) includes symptoms such as hearing voices, believing in things that are not real despite evidence to the contrary (delusions) and paranoia. To be diagnosed with schizophrenia, an individual must have experienced more than one psychotic episode, along with other symptoms, within a six-month period. Please view this web page to read more about the specifics of a schizophrenia diagnosis.

It can be difficult to receive an accurate psychiatric diagnosis. It’s not uncommon for an individual to receive many different diagnoses. This is a common complaint among psychiatric patients. I’ve written about this topic before. Studies have shown that if three different trained mental health professionals are evaluating the same client, they may arrive at three different diagnoses. That is a common occurrence. Also, some psychiatric disorders have similar and perhaps overlapping symptoms. One example is major depressive disorder with psychotic features and schizophrenia. The symptoms of major depressive disorder with psychotic features can mimic the negative symptoms of schizophrenia such as flat affect, lack of motivation, and social withdrawal. Unfortunately, psychiatric diagnosis is not an exact science.

I would recommend trying to access high-quality treatment for your daughter rather than gaining a specific diagnosis. The goal for you and your daughter should be to connect with a highly-qualified therapist, psychiatrist and treatment team. More specifically, the mental health professionals you and she choose should focus on understanding your daughter’s needs, decreasing her symptoms and improving her quality of life. Your main goal should be to look for results-oriented treatment. Stay connected to the professionals who are actually able to help your daughter.

I hope you’re able to find high quality psychiatric help for your daughter. You may want to try this website to search for mental health professionals in your community. Lastly, I hope my answer clarifies the difference between psychosis and schizophrenia. If not, please do not hesitate to ask followup questions. I wish you well. Thanks for writing.

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Last reviewed: By John M. Grohol, Psy.D. on 2 Jun 2010

APA Reference
Randle, K. (2010). What Is the Difference Between Psychosis and Schizophrenia?. Psych Central. Retrieved on November 23, 2014, from http://psychcentral.com/ask-the-therapist/2010/06/02/what-is-the-difference-between-psychosis-and-schizophrenia/