Table 2.

Symptoms Potentially Suggestive of a Psychotic Mood Disorder, Not Schizophrenia, in Functionally Psychotic Patients

1. Paranoia (fear for one's life: punishment, poison, torture, execution)

2. Delusional grandiosity (valuable possessions)

3. Delusional guilt (past sins)

4. Persecution by high-profile groups (FBI, CIA, KGB, IRS, God, the devil, etc)

5. Psychosis (both mood-congruent and mood-incongruent hallucinations and/or delusions)

6. Atypical increase in goal-directed behavior/activities especially involving “spur of the moment” decisions: religious, legal, political, sexual, cleaning, phoning, writing, loud music, partying, travel

7. Atypical increase in emotion: anger, elation, irritability, intrusiveness, sadness, crying, suicidality

8. Absence of pleasure and/or emotion (depression): anhedonia, flat affect, avolition, alogia

9. Behavior causing disturbance: police called, assaultive, loud, neighbor's complaints

10. History of major depression or mania/hypomania

11. Family history of bipolar or major depression

12. DSM criteria for bipolar, manic, depressed, or mixed

13. Good premorbid or current social life: school officer, sports, gangs, dated, past long-term relationship, formally married, children

Note: FBI, Federal Bureau of Investigation; CIA, Central Intelligence Agency; KGB, (Soviet) State Security Committee; IRS, Internal Revenue Service; DSM, Diagnostic and Statistical Manual of Mental Disorders.