A common misconception is that Psychopathy ''rules out'' Psychosis, and that Psychotic diagnosis generally excludes Psychopathic personalities...however, there are no guarantee's with the human mind and Psychiatrists often come across individuals with traits of both disorders.
Psychopathy is a personality 'type' and a disorder characterized by primarily Bold & Egotistical traits [1] [2] [3], versus the traditional antisocial behavior spectrum which is characterized more by impulsivity, lack of responsibility and low empathy [4] [5] [6]. Psychopaths are more 'fearless' than those with Antisocial personality and generally have more narcissistic traits. They also are more callous, and display 'stress immunity' and lack of (or very little) nervousness.
Psychopathic individuals as well as your garden variety sociopath (antisocial personality) both often have other mental diagnosis, if they are in the system, that is. Those that are off-the-grid or live in complete isolation would not be counted in statistical analysis. Common co-occurring diagnosis with Psychopathy are Bipolar disorder and less often, Depressive disorders [7] [8] [9].
Psychopaths do often have Paranoid traits [10] [11] [12], and a smaller percentage exhibit complete megalomania and may often talk as if they are a God; otherwise 'special', or even invulnerable. However, hallucinations are almost never present and the delusions of grandeur do not impair these individuals as they are able to act and seem normal [13] [14].
In fact, most Psychopaths with semi-Psychotic traits only display them to certain people. They may even do so as a manipulation tactic [15] [16].
Psychopaths often present with Compulsive, fearless behavior, sometimes with Paranoid traits [17] [18].
There's also a subtype of Psychopathy which includes more social withdrawal.
This would be someone who is highly creative, intelligent and exhibits semi-Psychotic traits, possibly appearing almost Autistic in nature of their Interests, but possesses little to no Empathy - thus, they are the rare Psychopath with Schizoid personality subtype. These are types that spend their days dreaming of taking control of Businesses, Governments, gaining complete Power over others, and often live in Isolation with their evil fantasies as their main outlet.
The main answer to this question, can you be Psychopathic and Psychotic at the same time? No. They are generally mutually exclusive, but you can be a Psychopath with Paranoid and 'stable' delusional traits.
You can also be Psychotic with low empathy, but having a full-on Psychotic disorder usually (almost always) replaces ANY personality disorder as the primary diagnosis. Unless of course, the Psychosis is situational; either self-generated or drug-induced.
Further Elaboration on Specifics between Disorders
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Another way to distinguish the differences between each disorder and whether there are co-ocurring mental disorders is by the reactions the person presents with.
The reality is that a Sociopath, Psychotic and a Psychopath react very differently to Insults, Instigation and Stress.
In the case of a Sociopath; the response to any of the above is often hostile, out-of-place or uncalled for. A Psychotic may over-dramatize their response, act especially eccentrically, say weird things in response that do not seem to relate (as in thought-disorder) or may appear almost BiPolar.
A Psychopath would however, discriminate their response based on the person causing the Insult, would use their people-reading skills and Intelligence to direct a non-wasted effort in Silencing the offending person. They would also be less emotionally affected and would plot their return statement carefully. Thus, as in with a business, a Psychopath would both escape repercussions and deliver an adequate proverbially decapitating response. While maintaining their Image. The result is that one type is better at self-preservation, including their emotional integrity and mental well-being than the other.
A general rule can be stated: Sociopaths are intent and hostile in response to Stress, Psychotics are vain, digressing from points and inconsistent, there are more variables and speech can be more unpredictable. Psychopaths calculate response based on best measurable outcome, and preserve face by responding efficiently and personalizing the response based on who they are talking to.
Remember that even though these are accurate assessments of each Personality Type; they are not always going to be 100% precise. There are always variables.
Cross-Over Traits in Children
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Children with Psychotic traits in some cases appear dissociated, erratic and often manic.
However despite popular belief, dissociation, insensitivity to Punishment and prank-pulling are actually more associated with childhood Psychopathy.
Psychopathic children are often found destroying school-property, others property and home property; throwing objects to prove a point or doing things to evoke a response can be a Psychopathic complex rather than attention-seeking. Though in all reality they can be both. Psychopathic children tend to behave in sadistic manner, and gain pleasure from upsetting or seeing people upset. They often manipulate adults at a Young age.
