‘Psychotic disorder refer to a group of conditions wherein individuals deviate from or lose touch with reality or, in the sense that they may see or hear things that aren’t there or harbor rigid beliefs that contradict reality. Such individuals also usually do not feel as though they suffer from any psychiatric condition,’ says Dr Samir Parikh, director, Mental Health and Behavioural Sciences, Fortis Hospitals.
Schizophrenia: It is a psychotic disorder that affects more than 21 million people worldwide (according to the World Health Organization) and is equally prevalent across different countries, including India. This disorder is a long-term involving behavioural changes, hallucinations and delusions, which usually lasts for 6 months or more.
Brief psychotic disorder: This type of psychosis lasts for a short period of time, with symptoms lasting for less than a month.
Delusional disorder: A person suffering from this type of disorder believes false things based on self-made assumptions despite the clear evidence to the contrary.
Schizoaffective disorder: This disorder is a mixture of several mental health conditions, wherein the person begins to hallucinate and becomes delusional. Symptoms like mania and depression may also be seen in a few cases.
Schizopherniform disorder: A person suffering from this disorder shows symptoms of schizophrenia but unlike schizophrenia, the symptoms last for one month or lesser than six months.
Shared psychotic disorder: This disorder is caused when a person becomes delusional after being in a relationship with or being in close proximity with a person who is delusional.
According to Dr Parikh, anyone can develop a psychotic disorder at some point in their life. 'Typically psychotic disorders manifest in late adolescence or early adulthood, but they can also occur in childhood or in one’s later years in some cases.' he says.
Although the exact cause of psychotic disorders is not known, there are several genetic, environmental and psychosocial factors that contribute to their development.
Genetic factors: In most of the cases, psychotic disorders run in families. Genes can play a predisposing role, making some people more susceptible to such disorders. There's a 10% chance that a child having a parent suffering from psychotic disorder will suffer from the same illness, while the risk is even greater in identical twins.
Environmental factors: Factors like stress, drug abuse, drinking problem, domestic violence, abusive childhoods and major life events can also trigger psychosis.
Psychosocial factors: Those already suffering from other mental health issues like anxiety disorder, depression or bipolar disorder have an increased risk of suffering from psychosis.
The symptoms of psychotic disorders include:
- Disorganized thought and speech
- Behavioural disturbances
- Disturbed motor movements
These symptoms can be accompanied by loss of motivation, loss of interest in activities and social withdrawal.
Apart from the generalized symptoms, Dr Parikh highlights behavioural changes in people suffering from psychotic disorder. 'Hallucinations and delusional behaviour at times lead to a heightened sense of fear in some patients. In some cases, the condition affects their thoughts to such an extent that they are unable to speak or express their thoughts in the right manner. They may withdraw from their friends and family, preferring to stay alone. Their personal hygiene may suffer as well. Such disorders tend to affect both one’s social life as well as one’s professional functioning. Unfortunately, individuals suffering from mental illness are additionally straddled with stigma and discrimination, thus making recovery that much more difficult,' he says.
'There are no laboratory tests that can help diagnose psychotic disorder at present. It is therefore diagnosed through a clinical interview with a psychiatrist, and may at times require a psychodiagnostic evaluation conducted by a clinical psychologist, 'explains Dr Parikh. The psychodiagnostic evaluation involves analysis of family history and the psychological state of the patient. Sometimes, medical tests may be conducted to rule out other conditions associated with similar symptoms.
Psychotic disorders cannot be cured. Treatment approaches are aimed at controlling symptoms and help patients live a satisfying life.
Medication: 'Psychotic disorders are caused due to an imbalance of neurotransmitters in the system, and therefore the treatment involves medications as directed by a psychiatrist,' says Dr Parikh. Antipsychotic medications like chlorpromazine and trifluoperazine work by helping the chemical imbalance restore. They effectively treat acute psychotic disorder and prevent future episodes of the disorder. Psychotic disorders triggered due to an underlying medical condition like depression are treated with medication for underlying condition.
Rehabilitation: Those suffering from psychotic disorders caused due to alcoholism or substance abuse may benefit more from rehabilitation and medical help to quit the habit apart from medication therapy alone.
Counseling and behavioural therapy: Counseling can go a long way in reducing symptoms in patients with psychotic disorders. It offers support not only to the patients but also to their family members. 'Once a patient’s health has improved, counseling and behavior therapy can also help the individual challenge their dysfunctional thoughts and adapt to the requirements of day to day living. It’s important to remember that a positive home environment can play a significant role in the recovery of such conditions, and so family therapy may also be beneficial,' says Dr Parikh.
The content has been verified by
Dr Samir Parikh
, Director, Mental Health and Behavioural Sciences, Fortis Hospitals, Gurgaon.