What is psychosis? D B Double

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Presentation transcript:

What is psychosis? D B Double

Symptoms Hallucinations Delusions Thought disorder 'Loss of contact with reality'

Disorders Schizophrenia Manic-depression (Bipolar disorder) Paranoid disorder (Delusional disorder) Psychotic depression

Classificatory criteria International classification of diseases (ICD) Diagnostic and statistical manual (DSM) of American Psychiatric Association Distinction between schizophrenia and manic-depression (bipolar disorder) Organic versus functional disorders

Epidemiology Most common risk period of first-episode psychosis is ages 14 to 35 Lifetime risk schizophrenia 1 in 100, and similarly for bipolar disorder Greatest risk of diagnosis of schizophrenia in socially deprived, especially young men 10-15% of population experience hallucinations at some point in their life

Outcome Less than a quarter remain permanently affected Third complete recovery Better outcome generally in developing countries than industrialised nations Sudden onset better outcome than gradual

Management Understanding in context Management of disturbance may require Mental Health Act Psychosocial interventions, support and facilitation of recovery Specific psychological treatments and family interventions Rehabilitation

Medication Traditional and atypical anti-psychotic drugs Acute and preventative treatment Mood-stabilising medication (Antidepressants and minor tranquillisers) Side effects and discontinuation problems

What is mental illness?

Conclusion - ? Brain disorder (such as chemical imbalance) Research not led to clear conclusions All experience and behaviour involves neurochemical changes and this is true for 'normal' as well as psychotic experience

Further reading Recent Advances in Understanding Mental Illness and Psychotic Experiences. British Psychological Society report (link)link Critical psychiatry website (

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