Which diagnosis features psychotic symptoms that occur exclusively during mood episodes?

• A. Depressive/Bipolar with Psychotic Features
• B. Schizoaffective disorder
• C. Schizophrenia
• D. Delusional disorder

Answer: (A)

The situation described is when psychotic symptoms appear only during active mood episodes and fade when mood improves. That pattern points to a mood disorder with psychotic features. When psychosis is tied exclusively to depressive or manic episodes, the psychotic symptoms are not present during euthymic periods, which is the hallmark of this diagnosis.

This differs from schizoaffective disorder, where psychotic symptoms also occur outside of mood episodes for a substantial period, so psychosis isn’t limited to mood states. It also differs from schizophrenia, where prominent psychotic symptoms persist independently of mood changes, with mood symptoms either absent or not a defining feature. Delusional disorder involves fixed delusions without prominent mood episodes driving the psychosis.

So, psychotic symptoms that occur exclusively during mood episodes align with mood disorders with psychotic features, and treatment typically targets both the mood disturbance and the psychosis during those episodes.