Psychotic Disorders

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PHSYCHOTIC DISORDERS

Phychotic disorders or psychoses are more “serious disorders” in comparison with the minor illnesses of neurotic disorder. A psychotic behavior is characterized by a serious form of personality disturbance in which the patient shows periodic or prolonged loss of contact with the reality. Legal and social term “insanity” is frequently used for the psychotic disorders.

General Symptoms:

  1. Mental functions are usually so disturbed that he is incapable of carrying out his daily activities.
  2. Manifests symptoms of delusions, hallucinations, stupor, incoherence, or violet reactions.
  3. More or less out of contact with reality.
  4. Lacks insight; that is he does not realize the psychological nature of his symptoms and disabilities.
  5. Behavior may be injurious to himself or to society.

Difference b/w psychotic and psychoneurotic disorders:

  1. Psychotic disorders affect the whole personality of the individual by completely disorganizing or splitting it, while neurotic disorders affect any parts of one’s personality and as a whole the neurotic personality remain intact.
  2. Psychotic disorders are major illnesses and involve such serious disorders of the mind where the patients lost contact with reality. Neurotic patients, on the other hand, never lose contact with reality and are able to make a reasonably adequate adjustment with environment.
  3. Psychotics need hospitalization as they are considered to be a potential danger to themselves and others and their behavior is predictable and uncontrollable. In the case of neurotics hospitalization is seldom necessary. Neurotics build castle in the air, while psychotics actually live in them. While a neurotic does not deny reality out merely attempts to ignore it, whereas the phychotic substitutes the reality with something else by completely denying.
  4. Psychotics rarely have insight into the nature of their behavior. Neurotic have insight into the nature of their behavior.
  5. Psychotic behavior is characterized by the symptoms of severe nature —- delusion, hallucinations, coma or stupor. Significantly, such disorders of thoughts are —- present in neurotic behavior.

Types of Psychotic Disorders:

Psychotic disorders are generally classified into two major groups the organic and the functional.

Organic Psychoses:

Organic mental disorders may be classified as acute, intermediate or chronic. An acute disorder is likely to be temporary and reversible, whereas a chronic disorder is irreversible because of permanent danger to the nervous system. In general, a disorder takes the form of acute or chronic in proportion to the issue loss and impairment of the function of the brain.

Causative factors:
  1. Infection of the nervous system.
  2. Trauma, natal and post natal physical; injuries affecting the central nervous system (cns).
  3. Intoxication-drugs, poisons, alcohol etc
  4. Endocrine disturbances.
  5. Circulatory dysfunctions
  6. Tumors, cancers,

Functional Psychoses:

Mental disorders exhibiting a change only in the functions of the brain and not in the brain structure are included in functional psychoses.

Brief Psychotic Disorder:-

  • Hallucinations, delusions, disorganized speech or end up in a catatonic state.
  • Somewhat similar symptoms as schizophrenia but never lasts longer than a month.
  • May affect individuals after a large stressful event.

Delusional disorder:

  • A person with this disorder has one or more non bizarre delusions
  • Others than having the delusions, the person goes on with his normal life activities. He may make some odd decisions based on his delusions, but these usually are not noticed by others.

Seven subtypes which are as follows:

Erotomanic Type:

The person believes a person of a higher social status is in love with him.

Grandiose Type:

Believes they are rich or powerful

Jealous Type

Believes his significant other is having affair.

Persecutory Type

Believes that loved one is treated badly.

Somatic Type:-

Believes he has a medical condition.

Mixed type:

Two are or more of above types are happening.

Schizophrenia:

main symptoms include delusions, hallucinations, disorganized speech, disorganized or catatonic behavior and negative symptoms (affective flattening, alogia or evolution), deterioration of adaptive behavour.

Types

Paranoid types:

  • This type is dominated with delusions of persecution, along with delusions of grandeur.
  • People believe that they have many enemies who want to harass and oppress them.
  • To make sense of his persecution, they often develop delusions of grandeur. They believe that they must be enormously important people.

Catatonic Type:-

  • Striking motor disturbances, ranging from muscular rigidity to random motor activity.
  • Catatonic stupor: extreme form of withdrawal remains virtually motionless and seems oblivious to the environment around them for long period of time.
  • Catatonic excitement: hyperactive and incoherent.
  • Some alternate between these dramatic extremes.

Disorganized Type:

  • Particularly server deterioration of adaptive behaviour is seen.
  • Common symptoms: emotional indifference frequent incoherence and virtually complete social withdrawal. Aimless babbling.
  • Delusions often center on bodily functions (my brain is meeting out my ears).

Undifferentiated Type:

  • People who are clearly schizophrenic but who cannot be placed in any of the three previous categories.
  • Marked by idiosyncratic mixtures of schizophrenic symptoms.

Schizoaffective Disorder:-

  • Characterized by all the symptoms of schizophrenia as well as those of Manic Episode, Major Depressive Episode or a Mixed Episode

Bipolar Type:

When manic or Mixed episode are part of the presentation. There is a chance that major depressive Episode may also occur.

Depressive Type:

Only major depressive Episode is present.

Shared Psychotic Disorder:

  • The silent feature is a delusion that develops in an individual who is involved in a close relationship with another person who already has a psychotic disorder with prominent delusions.
  • The delusion is similar to the one the already diagnosed person has.

Substance Induced Psychotic Disorders:

  • Caused by use of drugs and/or alcohol.
  • Main symptoms: delusion & hallucinations
  • Direct result of the physiological effects of the substances.

 

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