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. 2020 Apr;74(4):226-246.
doi: 10.1111/pcn.12966. Epub 2020 Feb 7.

Terminology and assessment tools of psychosis: A systematic narrative review

Natalie Seiler  1   2   3   4 , Tony Nguyen  1   2   3   4 , Alison Yung  1   2   4 , Brian O'Donoghue  1   2   4
Affiliations
Free article

Terminology and assessment tools of psychosis: A systematic narrative review

Natalie Seiler et al. Psychiatry Clin Neurosci. 2020 Apr.
Free article

Abstract

Aim: Phenomena within the psychosis continuum that varies in frequency/duration/intensity have been increasingly identified. Different terms describe these phenomena, however there is no standardization within the terminology. This review evaluated the definitions and assessment tools of seven terms - (i) 'psychotic experiences'; (ii) 'psychotic-like experiences'; (iii) 'psychotic-like symptoms'; (iv) 'attenuated psychotic symptoms'; (v) 'prodromal psychotic symptoms'; (vi) 'psychotic symptomatology'; and (vii) 'psychotic symptoms'.

Methods: EMBASE, MEDLINE, and CINAHL were searched during February-March 2019. Inclusion criteria included 1989-2019, full text, human, and English. Papers with no explicit definition or assessment tool, duplicates, conference abstracts, systematic reviews, meta-analyses, or no access were excluded.

Results: A total of 2238 papers were identified and of these, 627 were included. Definitions and assessment tools varied, but some trends were found. Psychotic experiences and psychotic-like experiences were transient and mild, found in the general population and those at-risk. Psychotic-like symptoms were subthreshold and among at-risk populations and non-psychotic mental disorders. Attenuated psychotic symptoms were subthreshold but associated with distress, risk, and help-seeking. Prodromal psychotic symptoms referred to the prodrome of psychotic disorders. Psychotic symptomatology included delusions and hallucinations within psychotic disorders. Psychotic symptoms was the broadest term, encompassing a range of populations but most commonly involving hallucinations, delusions, thought disorder, and disorganization.

Discussion: A model for conceptualizing the required terms is proposed and future directions needed to advance this field of research are discussed.

Keywords: psychiatry; psychology; psychotic disorders; schizophrenia; terminology.

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