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Schizophrenia and Other Psychotic Disorders

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What Causes Psychotic Disorders?

The exact cause of psychotic disorders is not known, but researchers believe that many factors may play a role. Some psychotic disorders tend to run in families, suggesting that the tendency, or likelihood, to develop the disorder may be partly inherited. Environmental factors may also play a role in their development, including stress, drug abuse, and major life changes.

In addition, people with certain psychotic disorders like schizophrenia may have abnormalities in the functioning of pathways in the brain that control thinking, perception, and motivation.  In schizophrenia, it is thought that nerve cell receptors that interact with a brain chemical called glutamate may not work properly in specific brain regions, and that this in turn may contribute to symptoms of abnormal thinking and perception. 

How Common Are Psychotic Disorders?

About 1% of the population worldwide suffers from psychotic disorders. These disorders most often first appear when a person is in his or her late teens, 20s, or 30s. They tend to affect men and women about equally.

How Are Psychotic Disorders Diagnosed?

If symptoms of a psychotic disorder are present, the doctor will perform a complete medical history and physical exam to determine the cause of the symptoms. Although there are no laboratory tests to specifically diagnose psychotic disorders -- except those that accompany a physical illness, such as a brain tumor -- the doctor may use various tests, such as blood tests and brain imaging (e.g., MRI scans), to rule out physical illness or intoxication with drugs like cocaine or LSD as the cause of the symptoms.

If the doctor finds no physical reason for the symptoms, he or she may refer the person to a psychiatrist or psychologist, mental health professionals who are trained to diagnose and treat mental illnesses. Psychiatrists use specially designed interview and assessment tools to evaluate a person for a psychotic disorder.

How Are Psychotic Disorders Treated?

Most psychotic disorders are treated with a combination of medications and psychotherapy (a type of counseling).

  • Medication: The main medications used to treat psychotic disorders are called antipsychotics. These medicines do not cure the illnesses but are very effective in managing the most troubling symptoms of psychotic disorders, such as delusions, hallucinations, and thinking problems. Antipsychotics include older medications such as Haldol, Thorazine, Loxapine, and Mellaril and newer medications (often called atypical antipsychotics) such as Abilify, Clozaril, Geodon, Invega, Latuda, Risperdal, Saphris, Seroquel, and Zyprexa. The newer medications are often considered first-line treatments because they have fewer and more tolerable side effects.
  • Psychotherapy: Various types of psychotherapy, including individual, group, and family therapy, may be used to help support the person with a psychotic disorder.

Most patients with psychotic disorders are treated as outpatients. However, people with particularly severe symptoms, those in danger of hurting themselves or others, or those unable to care for themselves because of their illness, may require hospitalization to stabilize their condition.

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