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Psychotic Disorders

What are they?

Everyone at some point has felt suspicious, thought they heard a voice or saw something that turned out not to exist, or stubbornly defended a point of view that won’t pass a reality check, but generally we adapt our points of view to reality and life goes on. Usually these are nothing more than normal doubts or false perceptions, and we remain open to having our beliefs or perceptions challenged by those around us.

However, if a person is unable to distinguish between their perceptions or beliefs and objective reality, these convictions may be psychotic. Generally, psychosis is characterized by a partial or complete loss of contact with reality and disorganization of the individual’s life, emotions, and personality.

Psychotic disorders strike about 2% of the population. Comparatively speaking, they are twice as common as Alzheimer’s disease and five times more prevalent than multiple sclerosis. They do not discriminate—they can affect children, adolescents, and adults of any age, no matter what their ethnic background, sex, social condition, or level of education.

There are a number of types of psychotic disorders. Each form entails loss of contact with reality sufficient to cause persistent suffering and interfere with the person’s ability to fulfill their professional, family, and social obligations.

The main types of psychotic disorders are:

  • Schizophrenia: This illness affects thoughts (delusional beliefs), perceptions (hallucinations), cognitive functions (memory, concentration, judgment, etc.), and emotions (anxiety, sadness, suspicion, etc.), although not necessarily all at the same time. It also has an impact on the person’s professional, social, and family life. 
  • Schizoaffective disorder: This condition is characterized by all the symptoms of schizophrenia as well as those of depression or mania. 
  • Delusional disorder: This illness mainly affects peoples’ thoughts (delusional beliefs). Their delusions may influence their emotions (euphoria and delusions of grandeur, suspicion, and the feeling of being persecuted) but apart from the effect on their judgment, they have normal cognitive functions, and the delusions don’t usually affect perception. Typically, the delusions concern only one part of a person’s life and can be categorized as either jealous, erotomanic (conviction that another person, often famous, is in love with the affected individual), persecution, somatic (conviction that the person has a disease or disability), or grandiose delusions. 
  • Brief psychotic episode: This is a rare condition that affects thoughts, oral communication, and perceptions in a somewhat similar way as schizophrenia, but never lasts longer than a month. The person goes back to functioning normally after the episode and often never has a relapse. 
  • Induced psychosis: drugs can cause psychosis in several ways. The very nature of certain drugs, LSD for example, affects perceptions and beliefs. These drugs induce the psychotic state that the drug user seeks, except in the case of a “bad trip” when the drug user loses control of the experience and becomes distressed. Other drugs are taken to alter emotions rather than perceptions but can sometimes induce psychosis that lasts several hours, days, or even weeks in the case of PCP. Also, drugs, even marijuana, can sometimes trigger illnesses such as schizophrenia.  

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What causes them?

We know that our brain cells are constantly communicating with each other through neurotransmitters. Neurotransmitters regulate our emotions, movements, thoughts, cognitive functions, (memory, concentration, judgment, etc.) and survival functions (sleep, appetite, digestion, elimination, pain control, reflexes, etc.).

In psychotic disorders, the neurotransmitters’ equilibrium is disturbed, but we don’t know why. There is no one cause of psychotic disorders; it probably results from a combination of factors that together lead to the onset of symptoms. These factors include:

  • Biological or genetic predisposition 
  • Abuse of, or sometimes simply use of, certain drugs 
  • Stress factors in a person’s life  

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What can be done?

Psychotic disorders are illnesses and they can be treated. 

Steps for action

Perhaps you recognize the symptoms described above, either in yourself or in someone you know. If so, a healthier lifestyle can help. Lifestyle changes won’t cure psychotic disorders but can eliminate the factors that can aggravate or contribute to them. Be sure to go to bed at a reasonable hour (lack of sleep can trigger a psychotic incident in people at risk), eat well (people experiencing a psychotic episode sometimes ignore their hunger and eat badly), exercise daily (for help with an exercise plan, visit www.0-5-30.com), and cut down on stimulants (coffee and tea, stimulating drinks), drugs, and alcohol (www.dependances.gouv.qc.ca). 

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You are concerned about a family member or a friend?

The refer-O-scope, a web-based tool, was developped by the Quebec Schizophenia society to help in the detection of early signs of symptoms of schizophrenia end related psychoses.

When to seek professional help

If you have experienced debilitating suffering for a number of days and are having difficulty meeting your professional or family obligations, you should see your family doctor or a psychologist. Don’t wait until you are incapable of functioning normally before seeking help. A professional can determine with you whether the problem is really a psychotic disorder and suggest a treatment plan adapted to your needs. A physical checkup and laboratory tests are sometimes necessary to eliminate other illnesses with symptoms similar to those of psychotic disorders.

If you have suicidal thoughts or fear for your safety or that of someone you know, call Info-Santé (telephone: 811) or see a doctor IMMEDIATELY.  

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How they are treated

There are proven treatments for psychotic disorders, and the sooner you consult a professional, the better the chances of a successful treatment. In most cases, a combination of psychotherapy and medication has been found to be very effective. Psychotic disorder experts generally recommend cognitive-behavioral therapy.

To find a psychotherapist with the approach that’s right for you and with whom you feel comfortable, ask your family doctor or contact the local health and social services center, Ordre des psychologues du Québec (http://www.ordrepsy.qc.ca/en/psychologue/definition.html), or Association des médecins psychiatres du Québec (www.ampq.org).

Antipsychotic medication acts by restoring the balance between the neurotransmitters in the brain that regulate emotions, cognitive function (memory, concentration, etc.), and somatic functions (sleep, appetite, energy, etc.). If your doctor prescribes medication, it is important to take it regularly. Be patient. Restoring balance to your brain can take time, sometimes up to several weeks. To avoid a relapse, it is very important to continue the treatment as prescribed even if you are feeling better. Treating a psychotic episode can take anywhere from several months to one or two years, depending on its severity.

The purpose of an antipsychotic drug is to eliminate rather than just reduce or partially reduce symptoms. Sometimes, medication can cause side effects. If so, be sure to tell your doctor. Don’t stop taking your medication before talking with your doctor. Another drug may be appropriate. 

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For information or help

The following are some useful links for getting emergency help or more information:

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