Psychotic Disorders

You can find heaps of information online about Psychotic Disorders – a broad term referring to the Category of Mental Disorder where hallucinations, delusions (abnormal paranoid beliefs), loss of touch with reality and disorganised thinking and behaviour frequently occurs. Most of this online information is a regurgitation of symptoms from the classification ‘bible’ DSM-5, which lists the features of different diagnoses like the ingredients of a cookbook! Despite these ‘descriptions’ being easily available, all the publicity about more common disorders has meant that education about ‘psychotic disorders’ has has been completely neglected so the stereotypes and misunderstandings abound.  Another reason for dissatisfaction about the quality of information available about psychotic disorders is that the DSM-5 classification system does not provide any ‘explanations’ or ‘causes’ and hence there is a lack of education about causes to the general public. Even we psychiatrists have not categorised causes in a way that is easily understood by the public, beyond using the term ‘biopsychosocial’ amongst ourselves, which refers to the biological, psychological and social factors contributing to any individual case of disorder. Because we have failed to adequately educate the public about these causes, I have ‘given a go’ to fill this gap in my eLearning education program!

 

In fact, there are 3 different ‘types’ of ‘Psychosis’ that we psychiatrists diagnose to help treat our patients. And an individual with ‘Psychosis’ might have a mixture of more than one cause. Hence, those with Psychosis often get the best outcomes from combinations of approaches – a management package – sometimes by more than one type of Help-Provider. Despite this, the treatment approach many people receive is too often dictated by the setting where the person goes for help or the type of Help-Provider a person seeks help from: some Help-Providers only offer medication, others only psychotherapy, some only life coaching, some only positive lifestyle factors. Whilst in many cases that may be adequate, what if it doesn’t adequately facilitate  recovery? 

Because each type of Psychosis tends to have a dominant cause, I’ve gone ‘Beyond DSM-5’ to divide all the common 6 Categories of Disorder (Mood, Anxiety, Personality, Psychotic, Substance Use and Eating Disorders) into 3 Explanatory SubTypes that reflects how most psychiatrists conceptualise mental health problems. 

For Psychotic Disorders, I have placed each of the 16 different types of ‘Psychosis’ into 1 of their 3 causative subtypes: 
1.     The Mind subtype due to an underdeveloped or immature capacity for decision-making and coping skills and unhelpful scripts. This tends to explain 1 Psychosis diagnosis: (1) Psychotic Disorder-Mind Subtype (AKA stress-induced psychosis, micro-psychotic episode, folie a deux, shared psychosis, brainwashing, Ganser syndrome)
2.     The Body subtype is due to ‘runaway feedback loops’ causing physical distress due to anxiety, pain, fatigue or nausea. This covers 1 diagnosis: (2) Psychotic Disorder-Body Subtype  (a.k.a. anxious beliefs with delusional intensity) 
3.     The Brain subtype is due to malfunctions, injuries & glitches. This explains 1 diagnosis: (3) Psychotic Disorder-Brain Subtype (a.k.a. schizophreniform disorder, chronic schizophrenia, schizoaffective disorder, organic psychotic disorder, drug-induced psychotic episode)
 
Ok, but what is the common mechanism that leads to Psychosis? Well, when there are ‘crossed wires’, short-circuits or ‘blown fuses’ or underdeveloped connectivity between certain brain areas or you have been brainwashed then all those pathways may lead to psychotic symptoms. I have depicted all of this information  pictorially, conversationally and pragmatically in eLearning

 

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