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Psychosis : people without labels.


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)
  • Disorganized thoughts process
  Positive symptoms are generally treated by typical antipsychotic drugs.

 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




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