Psychotic disorders are a group of serious mental illnesses. They lead to a violation of the clarity of thinking, the ability to make correct judgments, respond emotionally, communicate with people and adequately perceive reality. People with severe symptoms of the disease are often unable to cope with everyday tasks. Interestingly, most often such deviations are observed in residents of developed countries.
However, even severe types of diseases are more or less amenable to drug treatment.
Definition
Psychotic-level disorders cover a range of illnesses and related symptoms. In fact, such disorders are some forms of altered or distorted consciousness that persist for a significant period of time and prevent the normal functioning of a person as a full-fledged member of society.
Psychotic episodes may appear as an isolated incident, but most often they aresign of a significant mental he alth disorder.
Risk factors for psychotic disorders include heredity (especially schizophrenia), frequent drug use (mainly hallucinogenic drugs). The onset of a psychotic episode can also trigger stressful situations.
Views
Psychotic disorders have not yet been fully considered, some points are different depending on the approach to their study, so there may be some disagreement in the classifications. This is especially true for schizoaffective disorders, due to conflicting data on the nature of their occurrence. In addition, it is not always possible to clearly determine the cause of a particular symptomatology.
However, the following main, most common, types of psychotic disorders can be distinguished: schizophrenia, psychosis, bipolar disorder, polymorphic psychotic disorder.
Schizophrenia
This condition is diagnosed when symptoms such as delusions or hallucinations have been present for at least 6 months (with at least 2 symptoms continuously present for a month or more), with associated behavioral changes. Most often, this results in difficulty performing everyday tasks (for example, at work or in school).
Diagnosis of schizophrenia is often complicated by the fact that similar symptoms can occur with other disorders, and often patients mayto be cunning about the degree of their manifestation. For example, a person may not want to admit to hearing voices because of paranoid delusions or fear of stigmatization, and so on.
Also highlighted:
- Schizophreniform disorder. It includes the symptoms of schizophrenia, but lasts for a shorter period of time: from 1 to 6 months.
- Schizoaffective disorder. It is characterized by symptoms of both schizophrenia and diseases such as bipolar disorder.
Psychosis
Characterized by some distorted sense of reality.
A psychotic episode may include so-called positive symptoms: visual and auditory hallucinations, delusions, paranoid reasoning, disorientation of thinking. Negative symptoms include depressed mood, difficulties in constructing indirect speech, commenting and maintaining a coherent dialogue.
Bipolar disorder
Affective disorder characterized by extreme mood swings. The state of people with this disease usually changes dramatically from maximum arousal (mania and hypomania) to minimum (depression).
Any episode of bipolar disorder can be characterized as "acute psychotic disorder", but not vice versa.
Some psychotic symptoms can only appear during mania or depression. For example, during a manic episode, a person may experience grandiose feelings and believe that he hasincredible abilities (for example, the ability to always win any lottery).
Polymorphic psychotic disorder
It can often be mistaken for a manifestation of psychosis. Since it develops like psychosis, with all the accompanying symptoms, but also it is not schizophrenia in its original definition. Refers to a type of acute and transient psychotic disorders. Symptoms appear unexpectedly and constantly change (for example, a person sees new, completely different hallucinations each time), the overall clinical picture of the disease usually develops rather quickly. A similar episode lasts, as a rule, from 3 to 4 months.
Distinguish polymorphic psychotic disorder with and without symptoms of schizophrenia. In the first case, the disease is characterized by the presence of signs of schizophrenia, such as long-term persistent hallucinations and a corresponding change in behavior. In the second case, they are unstable, visions often have a fuzzy direction, a person's mood is constantly and unpredictably changing.
Symptoms
Both in schizophrenia, and in psychosis and all other similar types of diseases, a person always has the following symptoms that characterize a psychotic disorder. Often they are called "positive", but not in the sense that they are good and useful to others. In medicine, a similar name is used in the context of the expected manifestations of a disease or a normal type of behavior in its extreme form. For positive symptomsinclude hallucinations, delusions, strange body movements or lack of movement (catatonic stupor), peculiar speech, and strange or primitive behavior.
Hallucinations
Include sensations that do not have a corresponding objective reality. Hallucinations can manifest in various forms, parallel to human feelings.
- Visual hallucinations include optical illusions and seeing non-existent objects.
- Auditory, the most common type, includes voices in the head. Sometimes these two types of hallucinations can be mixed, that is, a person not only hears voices, but also sees their owners.
- Olfactory. A person smells non-existent smells.
- Somatic. The name comes from the Greek "soma" - the body. Accordingly, these hallucinations are bodily, for example, the sensation of the presence of something on the skin or under the skin.
Mania
This symptom most often characterizes an acute psychotic disorder with symptoms of schizophrenia.
Manias are strong irrational and unrealistic human beliefs that are difficult to change, even with overwhelming evidence. Most non-medical people believe that mania is just paranoia, persecution mania, excessive suspicion, when a person believes that everything around him is a conspiracy. However, this category also includes unfounded beliefs, manic love fantasies and jealousy,bordering on aggression.
Megalomania is a common irrational belief that exaggerates the importance of a person in various ways. For example, the patient may consider himself a president or king. Often megalomania acquires a religious connotation. A person may consider himself a messiah or, for example, sincerely assure others that he is the reincarnation of the Virgin Mary.
Misconceptions related to the characteristics and functioning of the body can also often arise. There were cases when people refused to eat because of the belief that all the muscles in the throat were completely paralyzed and all they could swallow was water. At the same time, there were no real grounds for this.
Other symptoms
Other symptoms tend to characterize short-term psychotic disorders. These include strange body movements, constant grimaces and facial expressions that are uncharacteristic of a person and situation, or, as an opposite, catatonic stupor - lack of movement.
Speech distortions occur: wrong sequence of words in a sentence, answers that make no sense or do not relate to the context of the conversation, mimicking an opponent.
There are also often aspects of childishness: singing and jumping in inappropriate circumstances, moodiness, unusual use of ordinary objects, such as creating a tinfoil hat.
Of course, a person with psychotic disorders will not have all the symptoms at the same time. Diagnosis is based on the presence of one or moresymptoms over time.
Reasons
The following are the main causes of psychotic disorders:
- Reaction to stress. From time to time, with severe prolonged stress, temporary psychotic reactions may occur. At the same time, the cause of stress can be both situations that many people encounter throughout their lives, for example, the death of a spouse or divorce, or more severe ones - a natural disaster, being in places of military operations or in captivity. Usually the psychotic episode ends as the stress decreases, but sometimes the episode can be prolonged or become chronic.
- Postpartum psychosis. In some women, significant hormonal changes resulting from childbirth can cause an acute psychotic disorder. Unfortunately, these conditions are often misdiagnosed and treated, resulting in new mothers who kill their babies or commit suicide.
- Defensive reaction of the body. It is believed that people with personality disorders are more susceptible to stress, they are less adapted to adulthood. As a result, when life circumstances become tougher, a psychotic episode can occur.
- Psychotic disorders due to cultural characteristics. Culture is an important factor in determining mental he alth. In many cultures, what is usually considered a deviation from the accepted norm of mental he alth is part oftraditions, beliefs, reference to historical events. For example, in some regions of Japan, there is a very strong, even manic, belief that the genitals can shrink and retract into the body, causing death.
If a behavior is acceptable in a given society or religion and occurs in appropriate settings, then it cannot be diagnosed as an acute psychotic disorder. Treatment is therefore not required under these conditions.
Diagnosis
In order to diagnose a psychotic disorder, a general practitioner needs to talk with the patient, as well as check the general state of he alth in order to rule out other causes of such symptoms. Most often, blood and brain tests are performed (for example, using MRI) to rule out mechanical damage to the brain and drug addiction.
If no physiological reasons for this behavior are found, the patient is referred to a psychiatrist for further diagnosis and determination of whether the person actually has a psychotic disorder.
Treatment
The most common treatment for psychotic disorders is a combination of medication and psychotherapy.
Neuroleptics or atypical antipsychotics are most often prescribed by specialists as a drug, effective for stopping such disturbing symptoms as delusions, hallucinations and a distorted perception of reality. These include: "Aripiprazole", "Azenapine",Brexpiprazole, Clozapine and so on.
Some drugs are available as tablets to be taken daily, others as injections to be given once or twice a month.
Psychotherapy includes various types of counseling. Depending on the personality of the patient and how the psychotic disorder proceeds, individual, group or family psychotherapy may be prescribed.
Most people with psychotic disorders are treated as outpatients, meaning they are not permanently in a medical facility. But sometimes, if there are severe symptoms, the threat of harm to yourself and loved ones, or if the patient is not able to take care of himself, hospitalization is made.
Each patient undergoing treatment for a psychotic disorder may respond differently to therapy. For some, progress is noticeable from the first day, someone will need months of treatment. Sometimes, if there are several severe episodes, it may be necessary to take medications on an ongoing basis. Usually, in such cases, a minimum dose is prescribed in order to avoid side effects as much as possible.
There is no way to prevent psychotic disorders. But the sooner you seek help, the easier the treatment will be.
People at high risk of developing these disorders, such as those with schizophrenic close relatives, should avoid alcohol and all drugs.
