Psychotic Disorders

Believing your pet can talk to you or that you’re actually living in the movie the Matrix may sound interesting to the average person, but it is a much more serious condition for the person who really believes and lives in that world. Read on to find out what causes psychotic disorders, how to treat them and more.

What is a Psychotic Disorder?

Psychosis, in general, is a mental condition that affects a person’s perception of reality that is often accompanied by delusions and/or hallucinations. Psychosis is a symptom of some of the more severe forms of mental health problems – grouped as psychotic disorders – such as schizophrenia and bi-polar disorder. These illnesses alter a person’s ability to think clearly, make good judgments, respond emotionally, communicate effectively, understand reality and behave appropriately.[1,2,3]

Types of Psychotic Disorders

There are several types of psychotic disorders, including the following:

Schizophrenia. Schizophrenia is a group of severe brain disorders in which people interpret reality abnormally. Schizophrenia may result in some combination of hallucinations, delusions and disordered thinking and behavior.[4]

Schizoaffective Disorder. A condition in which a person experiences a combination of schizophrenia symptoms — such as hallucinations or delusions — and of mood disorder symptoms, such as mania or depression.[5]

Schizophreniform Disorder. People with this illness have symptoms of schizophrenia, but the symptoms are milder and last between one and six months. People with this condition are able to function socially and work during this episode.[6]

Brief Psychotic Disorder. People with this illness experience delusions, hallucinations, and/or disorganized speech and behavior that lasts at least one day, but not longer than one month, and is usually the result of a very stressful event, such as a death in the family.[7]

Delusional Disorder. People with this condition have one or more non-bizarre delusions, or false beliefs, involving real-life situations, such as being stalked, being loved or deceived or having an illness.[8]

Shared Psychotic Disorder. This illness occurs when an otherwise healthy person develops delusions of a person with a psychotic disorder, such as schizophrenia. For example, a person with a psychotic disorder believes the government is spying on him or her. The person with shared psychotic disorder will also begin to believe that the government is spying on him or her. The delusions for the otherwise healthy person usually disappear when the people are separated.[2]

Substance-Induced Psychotic Disorder. This condition is caused and sustained by intoxication or withdrawal from certain substances, such as alcohol, amphetamines, hallucinogens and cocaine, that may cause hallucinations, delusions or confused speech.[9]

Bi-polar Disorder. Bi-polar disorder, also known as manic depression, is a mood disorder involving high to low swings in a person’s mood. These euphoric to depressed changes in behavior affect about one in 100 people and vary in occurrence from person to person; that is, some people have mood swings every few days, while others go long periods without experiencing problems.[10]

Signs & Symptoms of Psychotic Disorders

Although symptoms of a psychotic disorder vary from person to person and may change over time, hallucinations and delusions are the two most obvious symptoms.[2]

Hallucinations. Hallucinations are unusual sensory experiences or perceptions of things that aren’t actually present, such as seeing things that aren’t there, hearing voices, smelling odors, having a “funny” taste in your mouth, feeling sensations on your skin even though nothing is touching your body, and sensing things that other people can’t.[1,11]

Delusions. Delusions are irrational and unfounded beliefs that are persistent and organized, and that do not go away after receiving logical or accurate information. For example, a person who is certain his or her food is poisoned, even if it has been proven that the food is fine, is suffering from a delusion.[1,11]

Other possible symptoms of psychotic illnesses include:[12]

  • Odd or bizarre behavior
  • Odd or irrational beliefs
  • Changes in thinking or speech
  • Suspiciousness or paranoia
  • Decrease in personal hygiene
  • Social withdrawal
  • Preoccupation with a particular topic
  • Marked changes in emotion

Causes of Psychotic Disorders

The exact cause of psychotic disorders is not known, but researchers believe that many factors may play a role. Some psychotic disorders tend to run in families, suggesting that the tendency, or likelihood, to develop the disorder may be inherited. Environmental factors may also play a role in their development, including stress, alcohol and drug abuse and major life changes.[3,13] In addition, people with certain psychotic disorders may have an imbalance of certain chemicals in the brain. They may be either very sensitive to or produce too much of a chemical called dopamine. Dopamine is a neurotransmitter, a substance that helps nerve cells in the brain send messages to each other. An imbalance of dopamine affects the way the brain reacts to certain stimuli, such as sounds, smells, and sights, and can lead to hallucinations and delusions.[13]

Stress and social isolation are believed to play roles in the development of some forms of psychotic disorders, such as shared psychotic disorder.[2]

A number of substances and medical conditions can cause psychotic disorders, including the following:[3]

  • Some prescription drugs, such as steroids and stimulants
  • Brain tumors or cysts
  • Stroke
  • Dementia, including Alzheimer’s disease
  • Some types of epilepsy
  • Degenerative brain diseases, such as Parkinson’s disease, Huntington’s disease and certain chromosomal disorders
  • HIV and other infections that affect the brain

Effects of Psychotic Disorders

Untreated, people with some forms of psychotic disorders may lead lonely lives and have trouble functioning socially, holding down a job or attending school. They may rely heavily on family or live in psychiatric group homes.[4,5]

Tests for Psychotic Disorders

In order to diagnose the cause of a psychotic disorder, psychiatric evaluation and testing are conducted. Although laboratory testing and brain scans may not be needed, these techniques can sometimes assist in pinpointing the diagnosis. Tests may include the following:[3]

  • MRI of the brain
  • Blood tests for syphilis and other infections
  • Blood tests for abnormal electrolyte and hormone levels
  • Drug screens

Treatments for Psychotic Disorders

Even the most severe psychotic disorders are usually treatable. Most psychotic disorders are treated with a combination of medications and psychotherapy.[3,13]

Medications. The main medications used to treat psychotic disorders are called antipsychotics. These medicines do not cure the illnesses, but are very effective in managing the most troubling symptoms of psychotic disorders, such as delusions, hallucinations and thinking problems. Antipsychotics include older medications such as Haldol, Thorazine, and Mellaril and newer medications (often called atypicals) such as Abilify, Clozaril, Geodon, Invega, Risperdal, Saphris, Seroquel, and Zyprexa. The newer medications — sometimes referred to as atypical antipsychotics — are considered first-line treatments because they have fewer and more tolerable side effects.[13]

Psychotherapy. Various types of psychotherapy, including individual, group and family therapy, may be used to help support the person with a psychotic disorder. Psychotherapy may help the person suffering from the condition recognize the delusion and correct the underlying thinking that has been affected.[2,13]

Most patients with psychotic disorders are treated as outpatients. However, people with particularly severe symptoms, those in danger of hurting themselves or others, or those unable to care for themselves because of their illness, may require hospitalization to stabilize their condition.[13]

References

  1. Mental Health Foundation. Psychosis. Retrieved May 12, 2013, from http://www.mentalhealth.org.uk/help-information/mental-health-a-z/P/psychosis.
  2. Cleveland Clinic. Shared Psychotic Disorder. Retrieved May 12, 2013, from http://my.clevelandclinic.org/disorders/psychotic_disorder/hic_shared_psychotic_disorder.aspx.
  3. Scripps. Psychosis. Retrieved May 12, 2013, from http://www.scripps.org/articles/2369-psychosis.
  4. Mayo Clinic. Schizophrenia. Definition. Retrieved May 6, 2013, from http://www.mayoclinic.com/health/schizophrenia/DS00196.
  5. Mayo Clinic. Schizoaffective disorder. Definition. Retrieved May 6, 2013, from http://www.mayoclinic.com/health/schizoaffective-disorder/DS00866.
  6. Community Counseling Services, Inc. Schizophreniform Disorder. Retrieved May 12, 2013, from http://www.hsccs.org/poc/view_doc.php?type=doc&id=8825&cn=7.
  7. Community Counseling Services, Inc. Brief Psychotic Disorder. Retrieved May 12, 2013, from http://www.hsccs.org/poc/view_doc.php?type=doc&id=8818&cn=7.
  8. Psychology Today. Delusional Disorder. Retrieved May 12, 2013, from http://www.psychologytoday.com/conditions/delusional-disorder.
  9. Community Counseling Services, Inc. Substance-Induced Psychotic Disorder. Retrieved May 12, 2013, from http://www.hsccs.org/poc/view_doc.php?type=doc&id=8821&cn=7.
  10. Mental Health Foundation. Bi-Polar Disorder (Manic Depression). Retrieved May 12, 2013, from http://www.mentalhealth.org.uk/help-information/mental-health-a-z/B/bi-polar.
  11. WebMD. Schizophrenia and Other Psychotic Disorders. Retrieved May 6, 2013, from http://www.webmd.com/schizophrenia/guide/mental-health-psychotic-disorders.
  12. Johns Hopkins Medicine. Early Psychosis Intervention Clinic (EPIC). Retrieved May 12, 2013, from http://www.hopkinsmedicine.org/psychiatry/specialty_areas/schizophrenia/patient_information/early_psychosis.html.
  13. WebMD. Schizophrenia and Other Psychotic Disorders (continued). Retrieved May 6, 2013, from http://www.webmd.com/schizophrenia/guide/mental-health-psychotic-disorders?page=2.

By C. J. Newton, MA, Counseling.info Editor

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