Psychotic disorders are a heterogeneous group of mental illnesses among its essential features include the presence of so- called "psychotic symptoms". Each disease has its own causes, durations and developments and it is essential for proper diagnosis and treatment.
The term 'psychotic' has historically been used to define various psychopathological states, whose main feature is an alteration of daily reality of the patient. People with this disorder perceive over a period of time an altered reality that is not living the rest of people but they themselves believe it true.
Among the common symptoms we highlight psychotic delusions, hallucinations and disorganized thinking, resulting in multiple occasions severe behavioral disturbances.
The feeling of unreality living sufferers generates anxiety and nervousness and makes them vigilant to everything around them, in some cases the emotional and social isolation.
The presence of psychotic symptoms can be located in many mental disorders from depressive episodes, toxic reactions to various substances, experiential responses to serious situations, personality disorders, bipolar affective disorder etc.. Undoubtedly the most serious disorder within the spectrum of psychosis is schizophrenia.
Psychotic disorders: schizophrenia
Schizophrenia represents more than 80% of cases of psychosis. This situation coupled with its high prevalence, the level of suffering of patients and their social and family environment, besides the high social and economic cost, becomes psychosis par excellence.
It is estimated that the prevalence of schizophrenia in the general population is 1%. There seems no distinctions of sex, it appears in all cultures and social strata although a significant number of patients are among the most disadvantaged social levels.
It may appear at any time of life, although there is a period between the ages of 18 and 25 years, which is more often the beginning. The age of onset is one of the factors that determines the prognosis, the sooner is the debut of the disease the prognosis is worse.
Other factors that will affect prognosis are premorbid adjustment, ie, how the person was before the debut of the disease and how was their cognitive performance. To the extent that the affected person had worked better from the point of social, family, in their academic life and / or work, the prognosis is better. Any change in these areas of your life prior to the crisis, condition the course and prognosis of the disease.
Causes of schizophrenia
From the point of view of the origin of the disease, so far it has not been able to identify what causes these serious disorders cause. Numerous data to be knowing about it, indicate its origin, maintenance and prognosis are due to a complex interaction of several factors.
genetic causes. Genes are biological elements through which family members can transmit the disease. It is not known for certain where lies or what this behavior, but it probably has to do with the maturation process of the central nervous system and the complex mechanisms that mediate communication with brain structures.
biochemical causes. In brain studies we found variations of certain chemicals such as dopamine, serotonin and glutamate. They are brain neurotransmitters and excess could be the cause of the onset of schizophrenia.
Alterations during pregnancy and / or childbirth. Certain changes during pregnancy or childbirth can generate this psychotic illness can be acquired during pregnancy or childbirth, or due to brain damage from other causes at the time. Today's findings agree that lesions found in patients correspond more with a neurodevelopmental variation with a neurodegenerative disease, although it is likely that both disorders can coexist in the same patient.
Symptoms of situations of psychosis in schizophrenia are varied and nonspecific, and there are no characteristic symptom of this disease only. However, the most common are: delusions (beliefs outside reality, that the patient is absolutely convinced them, the most common is paranoid or ideas of being persecuted), hallucinations (disturbances of perception in which patients hear voices, see objects that do not exist, etc.. The most common are auditory), disorganized thinking and behavior changes in relation to the experiences mentioned.
The appearance of these symptoms is not usually be abruptly or acute and is developing progressively. In some cases and as a result of consumption of toxic substances (cannabis, amphetamines, or other substances) the presentation is more acute. Many times the usual way of beginning, coincides with moodiness, social isolation, academic failure, irritability, behavioral changes, etc, but unfortunately do not have a prospective value and from the therapeutic point of view can not do anything except vigilance.
Treatment of schizophrenia
Treatment as such is established in psychiatry once found by the piscótico episode, this being a very controversial issue today. Most of the healthcare structures have opted for the formula to act once it is consolidated psychotic episode, the option of establishing preventive therapeutic options, unfortunately have not met their expectations and little can be done to date.
Once psychotic symptoms treatment should be exclusively pharmacological and should be implemented as soon as possible, both for the patient 's suffering as his family are present. For this we currently highly effective antipsychotic drugs and with side effects that have significantly improved. Therapeutic compliance is one of the most common problems in addressing psychoses, there being a level of abandonment of high concern treatments. For that reason they have developed formulas antipiscóticos intramuscular long-term (one month) that promote compliance.
Obviously although pharmacological treatment is the fundamental treatment approach psychosis is not the only resource that can and should be implemented with psychological resources: programs psychoeducation, cognitive and social rehabilitation, social skills programs, etc, always oriented the phase in which the patient is.
Edited by Roser Berner Ubasos.