Psychosis affects an individual's thoughts, feelings and behaviours.
Some of the more characteristic symptoms include confused thinking,
delusions, hallucinations, changed feelings and changed behaviour.
A psychotic episode commonly isolates the person from others and
impairs family and social relationships. Difficulties in school
and work performance arise and secondary problems such as unemployment,
substance abuse, depression, self harm or suicide and illegal behaviour
can occur or intensify.
The experience of psychosis varies greatly from person to person
and individuals experiencing psychosis may have very different symptoms.
Diagnosing a psychotic episode in its early stage can be difficult.
Often, because psychosis affects young people, the early symptoms
are mistaken for normal teenage behaviour. Even when acute psychotic
symptoms are evident it is sometimes not properly diagnosed due
to lack of knowledge, dissatisfaction with mental health services
or a belief that making such a diagnosis would label or offend the
patient and/or family.
Diagnosis may take some time and can be frustrating for patients
and families who want to know what is happening.
How does the doctor decide on a
In order to properly diagnose what specific type of psychotic disorder
an individual has, patterns of symptoms must be assessed, often
over many months. A comprehensive assessment is more likely to lead
to a proper diagnosis. Medical professionals use information from
medical and family history along with a physical examination. Sometimes,
certain specialized types of assessments (such as a brain scan or
assessment of cognitive functioning) may aid in clarifying the specific
does the diagnosis change sometimes?
There are a range of disorders that can produce psychotic symptoms.
In first-episode psychosis, distinguishing between these disorders
can be difficult. Therefore, around 30-40% of diagnoses are changed
within three months.
Kinds of mental illness that may include psychosis
Psychosis is associated with several different mental and physical
disorders. Some examples are schizophrenia, schizophreniform disorder,
brief reactive psychosis, bipolar disorder, organic psychoses, delusional
disorder, drug-induced psychosis, psychotic depression and schizoaffective
Prognosis (do people recover?)
With appropriate treatments, the great majority of people recover
well from their initial episode of psychosis.
The pattern of recovery from psychosis varies from person to person.
Some people recover quickly with very little intervention. Others
may benefit from support over a longer period.
Following recovery from a first episode, a significant number of
people will never experience a second episode (called a relapse)
of psychosis. However, the risk of relapse is greatly increased
if medication and other treatments are discontinued too soon.
The likelihood of a complete and lasting recovery is much better
with proper treatment.
To many, mental illness is frightening. Unfortunately, this fear
can discourage people from seeking help early. Neither denial of
the problem nor delay will help a young person with psychosis. Much
of the fear surrounding mental illness is based on myths and misunderstandings.
Mental illness need not be feared. Like other medical conditions,
mental illness can be treated.
Some common myths about psychosis are that people with psychosis
have multiple personalities, that they are dangerous, and that they
never recover. In fact Multiple Personality Disorder is a rare condition
unrelated to psychosis; people with psychosis often withdraw and
are more of a danger to themselves than other people, and with current
treatments, most people make successful recoveries.
Education about psychosis is the best way to deal with the stigma.
Finding out what treatment is available, and how recovery is possible
can not only reduce some of the fear associated with psychosis,
but can also promote recovery by helping people anticipate and prepare
for what to expect from treatment and from themselves.