Psychosis Lecture

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**Lecture Notes: Understanding Psychosis**

**I. Introduction to Psychosis:**


- Definition: Psychosis is a mental health condition characterized by a disconnection from
reality, leading to impaired thinking, emotions, and behaviors.
- Core features: Hallucinations (perceiving things that aren't there), delusions (false
beliefs), disorganized thinking, and impaired social functioning.

**II. Types and Causes of Psychosis:**


- **Primary Psychotic Disorders:**
- Schizophrenia: Hallucinations, delusions, disorganized speech, and cognitive deficits.
- Schizoaffective Disorder: Features of schizophrenia along with mood disturbances
(depression or mania).
- **Secondary Psychotic Disorders:**
- Substance-Induced Psychosis: Resulting from substance abuse (e.g., drugs, alcohol).
- Psychosis Due to Medical Conditions: Caused by neurological disorders, infections, or
other medical conditions.
- **Brief Psychotic Disorder:** Sudden onset of psychotic symptoms, often triggered by
stress or trauma.

**III. Risk Factors for Psychosis:**


- Genetic predisposition: Family history of psychosis or other mental illnesses.
- Environmental factors: Childhood trauma, stress, substance abuse, urban living.
- Neurobiological factors: Brain abnormalities, neurotransmitter imbalances.

**IV. Clinical Presentation of Psychosis:**


- **Positive Symptoms:** Excesses or distortions of normal functioning.
- Hallucinations: Auditory, visual, tactile, olfactory, or gustatory.
- Delusions: Fixed false beliefs, often bizarre or paranoid.
- Disorganized thinking: Incoherent speech, tangentiality, or loose associations.
- **Negative Symptoms:** Deficits in normal functioning.
- Flat affect: Lack of emotional expression.
- Avolition: Lack of motivation or goal-directed behavior.
- Social withdrawal: Isolation and decreased engagement with others.

**V. Assessment and Diagnosis:**


- Comprehensive psychiatric evaluation: History, mental status examination, and collateral
information.
- Diagnostic criteria from the DSM-5 or ICD-10.
- Rule out medical conditions and substance use.

**VI. Treatment Approaches:**


- **Medication:**
- Antipsychotic medications: Typical and atypical agents to manage symptoms.
- Side effects: Extrapyramidal symptoms, metabolic changes, and agranulocytosis.
- **Psychotherapy:**
- Cognitive-behavioral therapy (CBT): Addressing delusions and hallucinations,
improving coping skills.
- Family therapy: Education, support, and communication training for families.
- **Hospitalization:** For acute episodes or safety concerns.
- **Community Support Services:** Rehabilitation, vocational training, and social support.

**VII. Prognosis and Long-Term Management:**


- Early intervention improves outcomes and reduces relapse rates.
- Long-term treatment with medication and therapy.
- Psychosocial interventions: Supportive housing, employment assistance, and peer
support groups.
- Regular monitoring for medication adherence, side effects, and relapse prevention.

**VIII. Ethical and Legal Considerations:**


- Informed consent for treatment, especially regarding medication.
- Rights of individuals with psychosis: Autonomy, privacy, and dignity.
- Legal issues: Involuntary hospitalization, guardianship, and competency evaluations.

**IX. Conclusion:**
- Psychosis is a complex mental health condition with various causes and presentations.
- Multidisciplinary approaches involving medication, therapy, and support services are
essential for effective management.
- Early intervention, education, and destigmatization are crucial for improving outcomes
and quality of life for individuals living with psychosis.

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