Psychosis
what does you thought it is, actually the correct definition of psychosis is currently not given by any scientist or doctor because we currently don't know much about it however Dr. T.suang gives the most appropriate definition of psychosis, according to him"it is psychiatric illness with serious distortion of thoughts, behaviour and capacity to recognise reality and perception". It is the fever of mental illness serious but not specific indicator.
It should be distinguished from term Insanity (where person is not responsible for his Criminal action).
Actually psychosis is a type of a mental illness.
The mental illness are divided into two categories
1) Neurosis: In neurosis insights present i.e patient is aware of his illness and he maybe ready to take medication.
Neurosis are following types
1.Anxiety (most common neurosis) unpleasant emotional state associated with uneasiness, worry, tension and concern for the future.
2. Phobia: Fear of the unknown or of some specific objects, person or situations.
3. Bulimia nervosa (eating disorder during stress)
4. Post traumatic stress disorder (PTSD)
5. Obsessive compulsive disorder (OCD):
Limited abnormality of thought or behaviour, recurrent intrusive thoughts or ritual-like behaviours which the patient realizes are abnormal or stupid, but is not able to overcome even on voluntary effort. The obsessions generate considerable anxiety and distress.
6. Reactive depression: due to physical illness, loss, blow to self-esteem or bereavement, but is excessive or dispro-
portionate.
2) Psychosis: Insight absent i.e patient is not aware of his illness and he may not be ready to take the medications.
Types of psychosis
1. Schizophrenia
2. Depression
3. Mania
4. Bipolar disorders
Schizophrenia
Generally schizophrenia is the most common type of psychosis so many people considered psychosis as schizophrenia, however it is a type of psychosis.
Schizophrenia is a mental disorder that usually appear in late adolescence or early childhood. It is psychiatric illness characterized by delusion, hallucination and other cognitive disturbances , schizophrenia may have life long suffering.
Approximately (0.5 to 1 %) of total world population is suffering from schizophrenia.
It is the most prominent psychiatric illness occur between age of 15 to 30 mostly and among these most sensitive age is 16 to 21 having maximum chance of occurrences of schizophrenia. some degree of schizophrenia maybe the part of life , but unfortunately 10 to 25% of patient committed suicide and half of these within few years of onset of illness.
symptoms of schizophrenia
Symptoms of schizophrenia are categorised into two categories:
A) Positive symptoms
These are less chronic symptoms
- Hallucination
- Delusion (false belief)
1) Delusion of grandeur (false belief of having great power and wealth)
2) Delusion of persecution (false belief of having negative impression or everybody against him)
Typical antipsychotic drugs generally treats schizophrenia by blocking D2 adrenergic receptors.
Typical antipsychotic drugs
B) Negative symptoms
They are more chronic symptoms and don't respond to typical antipsychotic drugs.
Negative symptoms involves the following symptoms:
To treat the negative symptoms atypical antipsychotics are generally used.
Atypical antipsychotics generally treat schizophrenia by various mechanisms I.e they don't have any specific mechanism of action.
These negative symptoms are so horrible that the patient might harm others or himself and they are not aware of their action.
Drugs belong to atypical categories are:
It is used generally for treatment of bipolar disorder.
Used for treatment of l-dopa induced psychosis
also used in treatment of bipolar disorder.
Causes of schizophrenia: The exact cause of schizophrenia it's still not known.
But, hypothesis says
genetics: it may be due to possible genetic predisposition on chromosome 6, 8 & 22.
Diseases: untreated diseases mainly viral over long period of time may couse schizophrenia.
Dopamine hypothesis: it is currently most accurate hypothesis regarding schizophrenia.
Dopamine hypothesis says that schizophrenia is due to dopaminerg over activity in limbic system.
so, treatment of schizophrenia involve increasing dopamine level in brain.
Adverse effect of antipsychotic drugs
2) Delusion of persecution (false belief of having negative impression or everybody against him)
- Disorganized thoughts process
Typical antipsychotic drugs generally treats schizophrenia by blocking D2 adrenergic receptors.
Typical antipsychotic drugs
- Chlorpromazine
- Triflupromazine
- Thioridazine
- Thiothixene
- Perphenazine
- Haloperidol
- Molindon
- Pimozide
- Loxapine
- Reserpine
B) Negative symptoms
They are more chronic symptoms and don't respond to typical antipsychotic drugs.
Negative symptoms involves the following symptoms:
- Decrease mental capacity
- Emotional withdrawal
- Loss of social drive
- Loss of speech
- Violent behaviour and suicidal tendency.
To treat the negative symptoms atypical antipsychotics are generally used.
Atypical antipsychotics generally treat schizophrenia by various mechanisms I.e they don't have any specific mechanism of action.
These negative symptoms are so horrible that the patient might harm others or himself and they are not aware of their action.
Drugs belong to atypical categories are:
- Resperidone : Alpha + 5HT2 + D4 receptor blocking action.
It is used generally for treatment of bipolar disorder.
- clozapine : Alpha + 5HT2 + D4 receptor blocking action.
Used for treatment of l-dopa induced psychosis
- olanzapine: Alpha1+2 +5HT2 + D2 receptor blocking action
also used in treatment of bipolar disorder.
- Aripiprazole: is partial agonist for 5HT1+ D2 receptor. It is called dopamine and serotonin stabilizer and act as 5HT2 antagonist.
- Zotepine
- Ziprasodone
Causes of schizophrenia: The exact cause of schizophrenia it's still not known.
But, hypothesis says
genetics: it may be due to possible genetic predisposition on chromosome 6, 8 & 22.
Unaffected blood relatives of schizophrenia patient have smaller size of hippocampus than normal individual i.e who doesn't have blood relation.
Environment: In presence of negative environment healthy person may suffered from schizophrenia.Diseases: untreated diseases mainly viral over long period of time may couse schizophrenia.
Dopamine hypothesis: it is currently most accurate hypothesis regarding schizophrenia.
Dopamine hypothesis says that schizophrenia is due to dopaminerg over activity in limbic system.
so, treatment of schizophrenia involve increasing dopamine level in brain.
Adverse effect of antipsychotic drugs
- Weight gain
- Hyperlipidemia
- Onset of diabetes
- Hyperprolactinemia
- Extrapyramidal disturbances
- Malignant neuroleptic syndrome
- Tardive dyskinesia
- Parkinsonism
- Acute muscular dystonia
- Retinal degeneration
- Cholestatic jaundice
- Anticholinergic effects
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