Person stares to the side or into a blank space, nods and gestures as though hearing conversation others do not hear this can be an indication of auditory and/or visual hallucinations. Listed with each behaviour are the diagnostic caveats which should be considered before making a definite attribution of psychosis.ġ. Listed below are some consistent nonverbal behaviours seen in persons with accurate diagnoses of schizophrenia or other conditions associated with psychosis. Some people who were initially nonverbal acquired speech and were able to provide additional contextual information. Nonverbal persons who exhibited similar behaviours were examined in regard to co-occurring symptoms and diagnoses, and specifically in regard to treatment outcome. The original list of observed behaviours that might be indicators of psychosis was developed by watching verbal persons with severe and persistent mental illness while they were experiencing psychotic symptoms, then asking them to place the symptoms in context (Ryan in Ancill et al 1994b). Thus, although careful observation is important, it is at least as important to interpret the observations in the context of the person’s other symptoms and life experiences. For example, a person who is experiencing a visual migraine aura might appear to be “looking at things that aren’t there”.
The examiner must not only make his or her own observations, but must also very intentionally gather the observational data from those who know the person well.Īn additional complicating issue is that many of the same behaviours that might indicate psychosis can also be indicators of equally significant but very different (and much more common) neuropsychiatric phenomena. One way to try to gather this information is to observe details of a person’s behaviour and compare these behaviours to those of persons with known psychotic symptoms. However, recognition of psychosis (hallucinations, delusions, or paranoia) requires the examiner to try to ascertain the internal perceptual experiences of persons who do not use the same primary spoken language as the examiner. For example, the criteria around sleep disturbance or appetite changes in diagnosis of mood disorders can be described by others who observe the person. Many standard psychiatric diagnostic criteria can be easily adapted to persons who do not use speech to communicate. Persons with intellectual disabilities (also called learning disability or mental handicap) and/or developmental disabilities such as autism are vulnerable to the same psychiatric conditions as anyone else (Szymanski et al 1990).