Psychosen

Psychoses, or psychotic disorders, refer to a class of mental health conditions characterized by impaired contact with reality. Core symptoms include delusions, hallucinations, disorganized thinking and speech, and abnormal or disorganized behavior. Negative symptoms such as reduced motivation, blunted affect, and social withdrawal may accompany the positive symptoms. Psychosis can occur in several conditions, most notably schizophrenia spectrum disorders, mood disorders with psychotic features, schizoaffective disorder, brief psychotic disorder, and delusional disorder. Psychosis may be primary or secondary to a medical condition, substance use, or delirium.

Onset is typically in late adolescence or early adulthood, but can occur at other ages. The clinical course is variable: some individuals experience a single episode with full recovery, others have relapses and a chronic or disabling illness. Early recognition and treatment are associated with better outcomes, and comprehensive care often reduces long-term disability.

Causes involve a complex interplay of genetic vulnerability, neurodevelopmental factors, and environmental stress. Neurobiological models highlight dysregulation of dopamine and other neurotransmitter systems. Risk factors include family history, obstetric complications, cannabis use in adolescence, psychosocial stress, and trauma. Diagnosis relies on clinical assessment using established criteria (DSM-5-TR or ICD-11) and careful exclusion of medical illness, substance-induced states, or delirium.

Treatment emphasizes antipsychotic medication, which can be typical or atypical, alongside psychosocial interventions such as cognitive behavioral therapy for psychosis, family education, and supported employment. Comprehensive care often includes case management and inpatient care when safety is a concern. With appropriate treatment and support, many individuals regain or preserve functioning, though some experience residual symptoms or relapses, underscoring the need for ongoing treatment and psychosocial support.