Psychosis
Overview
Psychosis refers to a mental health condition where individuals perceive or interpret reality in a significantly distorted way. This manifests through two main symptoms: hallucinations, where a person experiences things that aren't present (like hearing voices or seeing things that others can't), and delusions, where an individual holds false, fixed beliefs despite evidence to the contrary.
Psychosis can be a symptom of several mental health disorders, including schizophrenia, schizoaffective disorder, bipolar disorder, and severe depression. It can also be triggered by certain medical conditions, substance misuse, or extreme stress or trauma.
According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), psychosis is defined not as a disorder in itself, but as a symptom of other mental health disorders. Similarly, the International Classification of Diseases (ICD-11) and the World Health Organisation also define psychosis as a symptom rather than a standalone condition.
Types of psychosis include:
Schizophrenia: Schizophrenia is a severe and chronic mental disorder characterized by a combination of psychotic symptoms, such as hallucinations, delusions, disorganised thinking, and negative symptoms. It often involves significant impairments in social and occupational functioning.
Schizophreniform Disorder: Schizophreniform disorder shares similar symptoms with schizophrenia but is typically of shorter duration (less than six months). If symptoms persist beyond six months, the diagnosis may be changed to schizophrenia.
Schizoaffective Disorder: Schizoaffective disorder involves symptoms of both schizophrenia and mood disorders, such as depression or bipolar disorder. Individuals experience periods of psychosis along with mood disturbances, such as mania or depression.
Brief Psychotic Disorder: Brief psychotic disorder is characterised by the sudden onset of psychotic symptoms lasting less than one month. It may be triggered by significant stressors or traumatic events and often resolves spontaneously.
Substance-Induced Psychotic Disorder: Substance-induced psychotic disorder involves psychotic symptoms that are directly caused by substance use or withdrawal from substances, such as alcohol, stimulants, hallucinogens, or certain medications.
Psychotic Disorder Due to Another Medical Condition: Psychotic disorder due to another medical condition refers to psychosis that is caused by a medical condition or neurological disorder, such as brain injury, infection, or epilepsy.
Key Features
Hallucinations: Hallucinations involve perceiving sensations that are not real, such as hearing voices, seeing things that are not there, or feeling sensations on the skin.
Delusions: Delusions are false beliefs that persist despite evidence to the contrary. Common types of delusions include paranoid delusions (belief that others are plotting against or persecuting oneself), grandiose delusions (belief in one's exaggerated importance or abilities), and somatic delusions (belief in having a physical illness or deformity).
Disorganised Thinking: Disorganised thinking refers to difficulties in organising thoughts and expressing them coherently. This may manifest as incoherent speech, tangentiality (derailing from the topic), or loose associations (jumping from one unrelated idea to another).
Impaired Insight: Individuals with psychosis may have impaired insight into their condition, meaning they may not recognise that their perceptions or beliefs are distorted or unreal.
Negative Symptoms: Negative symptoms refer to a decrease or absence of normal functioning or behavior. This may include flattened affect (reduced emotional expression), avolition (lack of motivation or goal-directed behavior), anhedonia (loss of interest or pleasure), or social withdrawal.
How We Can Help
Psychologists play a critical role in managing psychosis. We provide comprehensive psychoeducation to help individuals and their families understand the nature of psychosis. We employ cognitive-behavioral therapy to help manage symptoms, challenge unhelpful beliefs, and promote healthier thought patterns. Furthermore, we can provide strategies for stress management, as stress can often exacerbate symptoms of psychosis.
Assessment and Diagnosis: Psychologists conduct comprehensive assessments to evaluate the nature and severity of psychotic symptoms, assess cognitive functioning, and identify any underlying psychological or social factors contributing to psychosis. This assessment helps in making an accurate diagnosis and developing an individualised treatment plan.
Psychotherapy: Psychotherapy is a key component of treatment for psychosis. Psychologists use various therapeutic approaches, such as cognitive-behavioral therapy for psychosis (CBTp), acceptance and commitment therapy (ACT), and supportive therapy, to help individuals understand and cope with their experiences, challenge distorted thoughts and beliefs, and develop strategies for managing symptoms and improving functioning.
Cognitive Remediation: Psychologists provide cognitive remediation interventions to help individuals with psychosis improve cognitive functioning, including attention, memory, problem-solving, and social cognition skills. Cognitive remediation may involve computer-based exercises, cognitive training tasks, and compensatory strategies to enhance cognitive abilities and daily functioning.
Social Skills Training: Psychologists offer social skills training to help individuals with psychosis improve their social functioning and interpersonal skills. This may include communication skills, assertiveness training, social problem-solving, and role-playing exercises to enhance social interactions and relationships.
Family Intervention: Psychologists provide family-focused interventions to educate and support family members of individuals with psychosis. Family interventions aim to reduce family stress, improve communication and problem-solving skills, enhance family support networks, and promote a positive and supportive family environment for the individual's recovery.
Psychoeducation: Psychologists offer psychoeducation to individuals and their families about psychosis, including its symptoms, causes, treatment options, and strategies for coping and recovery. Psychoeducation helps individuals and their families better understand the nature of psychosis, reduce stigma, and actively participate in treatment and support efforts.
Medication Adherence: Psychologists collaborate with psychiatrists or other medical professionals to promote medication adherence among individuals with psychosis. Psychologists provide psychoeducation about the importance of medication, address concerns or misconceptions about medication, and help individuals develop strategies for managing medication side effects and maintaining treatment adherence.
If you or someone you love is experiencing symptoms of psychosis, don't hesitate to reach out. Our team of compassionate and experienced psychologists is ready to support you through your journey. Call us now and take that first step towards understanding and managing psychosis.