Assessment in psychotic disorders should include evaluating cognition, depression, and mania to distinguish disorders.

• A. Cognition, depression, and mania
• B. Cognition only
• C. Depression only
• D. Mania only

Answer: (A)

Evaluating cognition, depression, and mania together captures how psychosis interacts with thinking and mood, which is crucial for differentiating psychotic disorders. Cognitive impairment is common and often persistent in schizophrenia-spectrum conditions, helping distinguish them from mood disorders with psychotic features where cognitive deficits may be less pronounced or tied to mood. Mood symptoms clarify mood-predominant conditions: if psychosis only occurs during depressive or manic episodes, it points to a mood disorder with psychotic features; if psychosis is present outside mood episodes, a schizoaffective or primary psychotic disorder becomes more likely. Mania or hypomania with psychosis specifically supports bipolar-type schizoaffective spectrum or bipolar disorder with psychotic features rather than a pure psychotic disorder. So a thorough assessment across cognition, depression, and mania yields the most accurate differential and informs treatment planning.

Focusing on cognition alone would miss mood patterns; mood symptoms alone could overlook persistent cognitive deficits; and mania alone would ignore depressive features and the timing of psychosis relative to mood.