What is Psychosis?

Psychosis or psychotic disorders include disorders in which people experience hallucinations, delusions, disorganized thinking or speaking, disorganized or abnormal motor behaviour, and negative symptoms (like blunting of feelings, apathy, loss of motivation and social interest). Brief psychotic disorder is one of the main disorders that are categorized by these symptoms however other disorders can include psychotic symptoms. Disorders in which people may experience psychosis include schizotypal personality disorder, delusional disorder, brief psychotic disorder, schizophreniform disorder, schizophrenia, schizoaffective disorder, and other disorders induced by medications or other substances.

Prevalence

The prevalence for psychosis depends on the type of psychotic disorder and whether it is someone’s first experience or not. In brief psychotic disorder for example, the prevalence is about 9% when we refer to the first onset. Brief psychosis is typically reported more in females than in males.

Signs and Symptoms

Delusions are strict beliefs that a person will not change despite there being evidence to the contrary. The beliefs can be about being harmed, that others are judging them, that they have exceptional abilities, wealth, or fame, that others are in love with them, that a major catastrophe will occur, or about health problems. Sometimes, delusions can be very bizarre and seem completely disconnected from reality, yet others may seem plausible but still not based on real evidence. Some people will experience hallucinations which are categorized as perceptions of experiences that are not experienced by others.

Hallucinations can be auditory (hearing voices), visual (seeing things that others don’t see), or tactile (feeling things that are not there).

Disorganized thinking or speech includes thoughts or speech that does not seem relevant to the situation or not related to a given conversation. It will be disorganized enough to impair communication with others.

Abnormal motor behaviour includes childlike “silliness” or agitation that seems unpredictable. These problems will affect normal daily functioning. Some will experience catatonic behaviour which is a severe decrease in movement or slowing of movement. Some people will have a bizarre posture and may not speak. Others will have excessive movement, stereotyped movement, staring, grimacing, mutism, or echoing of speech.

Treatment

Depending on the symptoms and whether the psychosis is part of another disorder, such as schizophrenia, treatment may be lifelong even if the symptoms subside. Psychotherapy and medication are typically helpful however hospitalization may be required in some extreme cases. A psychiatrist will be necessary for diagnosis and treatment with medication. They can also be in charge of psychotherapeutic treatment however there may be a treatment team that could include a psychologist or other mental health professional. Medications typically include antipsychotics. Psychotherapy may include individual therapy and family therapy to help the family cope with the symptoms as a group.

 

The DSM-5 Diagnostic and Statistical Manual of Mental Disorders 5

The Mayo Clinic: Mayoclinic.org

Video Resource: https://www.youtube.com/watch?v=YzDMl9cxwe8