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chotic disorders
Psychotic disorders
P s yc hos e s a r e c ha r a c te r is e d by d e lus ions . T he p a tie nt is c onv inc e d of things
tha t a r e not
r e a l, ba s e d on intuition, inte r p r e ta tion or ha lluc ina tions – e s p e c ia lly a ud itor y one s .
D e lus ion s a r e oft e n a c c om p a n ie d by be h a v iour d is or d e r s , for e xa m p le
a git a t ion ,
p r os tr a tion, m utis m , op p os ition, a nd fle e ing.
M a na ge m e nt inc lud e s p s yc hos oc ia l s up p or t a nd a ntip s yc hotic m e d ic a tion.
T r e a t m e n t e ffic a c y a n d t h e p r ogn os is d e p e n d in la r ge p a r t on t h e q ua lit y of
the
r e la tions hip e s ta blis he d w ith the p a tie nt a nd his fa m ily.
TK heee pminegathneinpgaoftiep sntyac thhoosme se vwaitrhieosutpwa itihe nthtefolclouwltu-ruapl icsopntreexfte r r. eFdorifethxea mp aptilee n, tpiss yc
not
a d a nge r to him s e lf or othe r s , a nd if the fa m ily is c a p a ble of m a na ging the
d is or d e r .
1
d is or d e r s m a y be a t t r ibut e d t o c h a r m s or t o a n c e s t or in t e r v e n t ion .
T h e r a p e ut ic
a p p r oa c h s h ould t a ke th os e be lie fs in to a c c oun t. P a tie n t a r e us ua lly a lr e a d y
un d e r
“tr a d itiona l” tr e a tm e nts , this s hould not be s e e n a s a n obs ta c le to c onv e ntiona l
m e d ic a l
tr e a tm e nt.
Acute psychotic episode
A n a c ute p s yc hotic e p is od e c a n be a one -tim e oc c ur r e nc e , us ua lly of s ud d e n
ons e t, or
c a n oc c ur r e p e a te d ly or m a y be t h e e a r ly p h a s e of c h r on ic p s yc h os is . I t c a n
oc c ur
follow ing a life e v e nt (e .g., los s , a c ute s tr e s s or tr a um a ). In p os tp a r tum p s yc hos is ,
the
d e lus ions c e ntr e on the m othe r -c hild r e la tions hip .
B e for e p r e s c r ibing a ntip s yc hotic m e d ic a tion, c ons id e r the p os s ibility of a n
und e r lying
or ga nic c a us e (s e e Mental confusion, p a ge 2 9 4 ) or us e of toxic s ubs ta nc e s .
A n t ip s yc h ot ic t h e r a p y is t h e s a m e a s t h a t for c h r on ic p s yc h os e s
( r is p e r id on e or
ha lop e r id ol, p a ge 3 0 1 ) a nd s hould la s t a t le a s t 3 m onths . A fte r 3 m onths , if the
p a tie nt is
s ta ble , s top the tr e a tm e nt gr a d ua lly ov e r 4 w e e ks , m onitor ing for p ote ntia l
r e la p s e .
F or s e v e r e a nxie ty or a gita tion, a n s h or t-c our s e a n xiolytic or s e d a tiv e tr e a tm e nt
(s e e
p a ge 3 0 2 ) m a y be a d d e d to the a ntip s yc hotic tr e a tm e nt, a t the be ginning of
tr e a tm e nt.
Chronic psychoses
Psychotic disorders
P s yc hos e s a r e c ha r a c te r is e d by d e lus ions . T he p a tie nt is c onv inc e d of things
tha t a r e not
r e a l, ba s e d on intuition, inte r p r e ta tion or ha lluc ina tions – e s p e c ia lly a ud itor y one s .
D e lus ion s a r e oft e n a c c om p a n ie d by be h a v iour d is or d e r s , for e xa m p le
a git a t ion ,
p r os tr a tion, m utis m , op p os ition, a nd fle e ing.
M a na ge m e nt inc lud e s p s yc hos oc ia l s up p or t a nd a ntip s yc hotic m e d ic a tion.
T r e a t m e n t e ffic a c y a n d t h e p r ogn os is d e p e n d in la r ge p a r t on t h e q ua lit y of
the
r e la tions hip e s ta blis he d w ith the p a tie nt a nd his fa m ily.
TK heee pminegathneinpgaoftiep sntyac thhoosme se vwaitrhieosutpwa itihe nthtefolclouwltu-ruapl icsopntreexfte r r. eFdorifethxea mp aptilee n, tpiss yc
not
a d a nge r to him s e lf or othe r s , a nd if the fa m ily is c a p a ble of m a na ging the
d is or d e r .
1
d is or d e r s m a y be a t t r ibut e d t o c h a r m s or t o a n c e s t or in t e r v e n t ion .
T h e r a p e ut ic
a p p r oa c h s h ould t a ke th os e be lie fs in to a c c oun t. P a tie n t a r e us ua lly a lr e a d y
un d e r
“tr a d itiona l” tr e a tm e nts , this s hould not be s e e n a s a n obs ta c le to c onv e ntiona l
m e d ic a l
tr e a tm e nt.
Acute psychotic episode
A n a c ute p s yc hotic e p is od e c a n be a one -tim e oc c ur r e nc e , us ua lly of s ud d e n
ons e t, or
c a n oc c ur r e p e a te d ly or m a y be t h e e a r ly p h a s e of c h r on ic p s yc h os is . I t c a n
oc c ur
follow ing a life e v e nt (e .g., los s , a c ute s tr e s s or tr a um a ). In p os tp a r tum p s yc hos is ,
the
d e lus ions c e ntr e on the m othe r -c hild r e la tions hip .
B e for e p r e s c r ibing a ntip s yc hotic m e d ic a tion, c ons id e r the p os s ibility of a n
und e r lying
or ga nic c a us e (s e e Mental confusion, p a ge 2 9 4 ) or us e of toxic s ubs ta nc e s .
A n t ip s yc h ot ic t h e r a p y is t h e s a m e a s t h a t for c h r on ic p s yc h os e s
( r is p e r id on e or
ha lop e r id ol, p a ge 3 0 1 ) a nd s hould la s t a t le a s t 3 m onths . A fte r 3 m onths , if the
p a tie nt is
s ta ble , s top the tr e a tm e nt gr a d ua lly ov e r 4 w e e ks , m onitor ing for p ote ntia l
r e la p s e .
F or s e v e r e a nxie ty or a gita tion, a n s h or t-c our s e a n xiolytic or s e d a tiv e tr e a tm e nt
(s e e
p a ge 3 0 2 ) m a y be a d d e d to the a ntip s yc hotic tr e a tm e nt, a t the be ginning of
tr e a tm e nt.
Chronic psychoses
