Psychotic disorders: symptoms and treatment

Psychotic disorders are a group of serious mental illnesses. They lead to a violation of clarity of thinking, the ability to make the right judgments, emotionally respond, communicate with people and adequately perceive reality. People with pronounced symptoms of the disease are often unable to cope with everyday tasks. It is interesting that most often such deviations are observed in the inhabitants of developed countries.

However, even severe types of diseases are more or less susceptible to drug treatment.

Definition

Psychotic disorders include a number of diseases and related symptoms. In fact, such disorders are some forms of altered or distorted consciousness that persist for a considerable period of time and interfere with the normal functioning of a person as a full member of society.

Psychotic episodes can appear as an isolated case, but more often than not they are a sign of a significant deviation in mental health.

The risk factors for the occurrence of psychotic disorders include heredity (especially in schizophrenia), frequent cases of drug use (mainly hallucinogenic drugs). The onset of a psychotic episode can also provoke stressful situations.

Kinds

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. In particular, this concerns schizoaffective disorders, because of conflicting data on the nature of their occurrence. In addition, it is not always possible to clearly identify the cause of this or that symptomatology.

Nevertheless, the following main, most common, types of psychotic disorders can be distinguished: schizophrenia, psychosis, bipolar disorder, polymorphic psychotic disorder.

Schizophrenia

This disease is diagnosed in cases of symptoms such as delusions or hallucinations, for at least 6 months (with at least 2 symptoms being treated continuously for a month or more), with appropriate behavioral changes. Most often, as a result, there are difficulties in performing daily tasks (for example, at work or during training).

Diagnosis of schizophrenia is often complicated by the fact that similar symptoms can occur in other disorders, and often patients can 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 highlight:

• Schizophreniform disorder. It includes the symptoms of schizophrenia, but lasts a shorter time interval: 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 can include so-called positive symptoms: visual and auditory hallucinations, delusions, paranoid reasoning, disoriented thinking. Negative symptoms include a depressed mood, difficulties in constructing an indirect speech, commenting and maintaining a coherent dialogue.

Bipolar disorder

Affective disorder characterized by sharp mood swings. The condition of people with a similar disease usually changes sharply from maximum excitation (mania and hypomania) to minimal (depression).

Any episode of bipolar disorder can be characterized as an "acute psychotic disorder", but not vice versa.

Some psychotic symptoms can only be manifested during the onset of mania or depression. For example, during a manic episode, a person can experience grandiose feelings and assume that he has incredible abilities (for example, the ability to always win in any lottery).

Polymorphic psychotic disorder

It can often be mistaken for a manifestation of psychosis. Since it develops like a psychosis, with all the attendant symptoms, but it is not schizophrenia in its original definition. It refers to the type of acute and transient psychotic disorders. Symptoms manifest suddenly and constantly change (for example, a person sees new, completely different hallucinations each time), the general clinical picture of the disease usually develops rather quickly. This episode lasts, as a rule, from 3 to 4 months.

Isolate a polymorphic psychotic disorder with symptoms of schizophrenia and without. In the first case, the disease is characterized by the presence of signs of schizophrenia, such as prolonged persistent hallucinations and a corresponding change in behavior. In the second case, they are unstable, visions often have a fuzzy focus, the mood of a person is constantly and unpredictably changing.

Symptoms

And with schizophrenia, and with psychosis and all other similar kinds of diseases, the following symptoms characterizing the psychotic disorder are always present in a person. Often they are called "positive", but not in the sense that they are good and useful to others. In medicine, this name is used in the context of expected manifestations of the disease or a normal type of behavior in its extreme form. Positive symptoms include hallucinations, delusions, strange gestures or lack of movement (catatonic stupor), peculiar speech and strange or primitive behavior.

Hallucinations

Include feelings that do not have a corresponding objective reality. Hallucinations can manifest themselves in various forms, parallel to human feelings.

• Visual hallucinations include deception and vision of non-existent objects.
• To the auditory, the most common type, are the 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 feels non-existent smells.
• Somatic. The name came from the Greek "soma" - the body. Accordingly, these hallucinations are bodily, for example, a sense of presence of something on the skin or under the skin.

Mania

This symptom most often characterizes an acute psychotic disorder with symptoms of schizophrenia.

Mania are the strong irrational and unrealistic beliefs of a person that are difficult to change, even if there is undeniable evidence. Most non-medical people believe that mania is only paranoia, persecution mania, excessive suspicion, when a person believes that everything around him is a conspiracy. However, this category also includes unreasonable beliefs, maniacal love fantasies and jealousy, bordering on aggression.

The megalomania is a common irrational belief, as a result of which the importance of man is exaggerated in various ways. For example, a patient may consider himself a president or a king. Often megalomania acquires a religious overtones. A person can consider himself a messiah or, for example, sincerely assure others that he is the reincarnation of the Virgin Mary.

Also, there can often be misconceptions related to the characteristics and functioning of the body. There have been cases when people refused to eat because of the belief that all the muscles in the throat are completely paralyzed and all that they can swallow is water. At the same time, there were no real grounds for this.

Other symptoms

Other signs, as a rule, characterize short-term psychotic disorders. These include strange body movements, permanent grimaces and uncharacteristic to the person and situations of facial expression or, as opposed to, catatonic stupor - lack of movement.

There are some distortions in speech: incorrect sequence of words in the sentence, answers that do not make sense or do not relate to the context of the conversation, mimicking the opponent.

Also often there are aspects of childishness: singing and jumping in improper circumstances, capriciousness, unusual use of ordinary objects, for example, the creation of a foil cap.

Of course, a person with psychotic disorders will not have all the symptoms at the same time. The basis for the diagnosis is the presence of one or more symptoms for a long time.

Causes

There are the following main causes of the onset 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 either the situations that many people face during their lifetime, for example, the death of a spouse or a divorce, or the more severe - a natural disaster, being in places of military operations or in captivity. Usually the psychotic episode ends with the reduction of stress, but sometimes this condition can drag on or go to a chronic one.
• Postpartum psychosis. In some women, a significant hormonal change resulting from childbirth can cause acute psychotic disorder. Unfortunately, such conditions are often misdiagnosed and treated, resulting in cases when a newly-made mother kills a child or commits suicide.
• Protective 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 the life circumstances become tougher, a psychotic episode can occur.
• Psychotic disorders due to cultural characteristics. Culture is an important factor in determining mental health. In many cultures, what is usually considered a deviation from the generally accepted norm of mental health is part of tradition, belief, reference to historical events. For example, in some regions of Japan, very strongly, down to mania, the belief that the genitals can contract and become entangled in the body, causing death.

If this or that behavior is acceptable in a given society or religion and occurs under the appropriate conditions, then it can not be diagnosed as an acute psychotic disorder. Treatment, respectively, under these conditions is not required.

Diagnostics

In order to diagnose a psychotic disorder, a general practitioner needs to talk with the patient, and also check the general health condition to rule out other reasons for the occurrence of such a symptomatology. Most often, blood and brain tests are performed (for example, using MRI) to exclude mechanical brain damage and drug addiction.

If no physiological reasons for this behavior are found, the patient is referred to a psychiatrist for further diagnosis and whether a given person actually has a psychotic disorder.

Treatment

Most often, a combination of drug treatment and psychotherapy is used to treat psychotic disorders.

As a medicine specialists usually prescribe neuroleptics or atypical antipsychotics, effective for stopping such anxious symptoms as delirium, hallucinations and distorted perception of reality. These include: "Aripiprazole", "Azenapine", "Brekspiprazole", "Clozapine" and so on.

Some drugs are available in the form of tablets, which must be taken daily, others - in the form of injections, which are enough to put one or two times a month.

Psychotherapy includes various types of counseling. Depending on the personal characteristics of the patient and the way the psychotic disorder proceeds, individual, group or family psychotherapy can be prescribed.

Most people with psychotic disorders go through outpatient treatment, that is, they are not permanently in a medical facility. But sometimes, in the presence of severe symptoms, the threat of harm to oneself and loved ones or if the patient is not able to take care of himself, hospitalization is performed.

Each patient undergoing treatment for a psychotic disorder may respond differently to therapy. Someone's progress is evident from the first day, someone will need months of treatment. Sometimes, in the presence of several severe episodes, you may need to take medication on an ongoing basis. Usually in such cases, a minimum dose is prescribed to avoid side effects as much as possible.

Prevent psychotic disorders can not. But the quicker you turn for help, the easier it will be to get treatment.

People at high risk for such disorders, for example those who have schizophrenics among close relatives, should avoid the use of alcohol and any drugs.