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Psychotic Disorders
What is a psychotic disorder?

A psychotic disorder is a severe medical illness that disturbs the way a person acts, thinks, see, hears or feels, and makes it difficult or impossible for him/her to distinguish between what is real and not.  Bipolar Disorder can have psychotic features.  Symptoms of psychosis may be either positive (something "added to" the person with the illness) ie something that is not always present or negative symptoms (something taken away or missing from the person when well)

Positive Symptoms

Delusions:  False personal beliefs that are not a part of the persons culture.

bulletthe person truly believes something that doesn't make sense to others around them
bulletreasoning with the person and showing them evidence that contradicts their belief doesn't convince them their belief is false.
bulletTypical examples include beliefs they are being plotted against, harmed or tormented
bulletDelusions are quite common in psychotic disorders

Hallucinations:  Sensing things that aren't really there

bulletThese include hearing, seeing, smelling tasting or touching things that others don't perceive.
bulletThe most common hallucination ids hearing voices that talk about the person, criticize them or tell them what they must do.

Disorganized Thinking:  Being  unable to "think straight"

bulletOrganizing thoughts is difficult, making it impossible to communicate clearly with others.
bulletUnable to concentrate on one though for long.
bulletThoughts are often blocked and fragmented.

Agitation or Excitement:  Appearing very excited, restless or hu\yperactive.

Grandiosity:  Believing they are powerful, very wealthy or have special powers

Suspiciousness:  Being mistrusting and guarded

bulletmight think they are being watched or followed

Hostility:  Behaving in an abusive, sarcastic and uncooperative manner


Negative Symptoms

Lack of Drive or Initiative:  Lack of energy to start or do anything - even simple tasks

Social Withdrawal:  Absorbed in own thoughts and senses

bulletspend most of time alone

Emotional Unresponsiveness:  Absence of feeling.

bulletmay feel less connected emotionally to what is going around them
bulletmay show inappropriate motions
bulletmay appear less emotionally responsive to their surroundings
bulletmay feel very little pleasure in doing things that are normally pleasurable

Lack of Spontaneity:  Hesitancy in speech or actions

bulletmovements may seem unnatural and slow

Difficulty in Abstract Thinking:  Concrete Thinking

bulletcan't see the underlying meaning of things
bulletcan't move from the specific to the general

Poor Communication Skills:  Avoids eye contact and conversation.

bulletin conversation may appear bored, uninterested or cold.

Stereotyped thinking:  Rigid attitudes and beliefs that may seem unreasonable to others

bulletthoughts may be repetitive and intrusive

Physical Symptoms:  Physical activity may slow down or stop

bulletmay be unconcerned with grooming and hygiene.


How Psychotic Symptoms are Treated

Depending on severity some psychotic disorders must be treated in hospital.  Some people may recover completely from a psychotic disorder.  Others may experience recurrent episodes.  The mainstay of treatment is medication, although therapy and rehabilitation may be required in addition.


Medication used to treat psychoses is called antipsychotic or neuroleptics (another less common term is major tranquilizers)  The older, or typical antipsychotics block dopamine in the brain and can cause some severe side effects like spasms and tardive dyskinesia.  The newer atypical antipsychotics achieve the same results with fewer of less severe side effects.  Risperdal is one such atypical antipsychotic - zyprexa is another.  The medication must often be taken over the long term not as a cure, but as a control of the psychotic symptoms.


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