It was identified by several biological markers that make it possible to classify mental disorders with greater precision. The findings may lead to improved diagnostics and treatments for those suffering from mental illness. Psychiatry still relies on symptoms as the basis of a diagnosis. It would be like using the presence of fever to diagnose a specific infection. We need some means to help us more accurately differentiate mental disorders. An experimental programme was created that uses neurobiological measures rather than symptoms to identify disease types.
They focused exclusively on patients suffering from psychosis – a broad category of mental disorder that includes schizophrenia, schizoaffective disorder and bipolar disorder with psychosis – to see if they could improve upon existing methods. The research team recruited more than 700 patients with psychosis and some of their first-degree relatives –a parent, sibling or child – as well as a control group of healthy individuals. Each participant went through a battery of tests designed to assess their cognitive abilities.
It was better able to predict who had family histories of psychoses, structural brain abnormalities and measures of social functioning. This project may inspire a renewed interest in psychiatric drug development, which has been stymied recently by a lack of clear biological targets. There was a long way from identifying specific disease mechanisms but it was just a step closer than, when focused on clinical symptoms alone.
Although the exact cause of psychotic disorders is not known, there are several genetic, environmental and psychosocial factors that contribute to their development.
Genetic factors: In most of the cases, psychotic disorders run in families. Genes can play a predisposing role, making some people more susceptible to such disorders. There’s a 10% chance that a child having a parent suffering from psychotic disorder will suffer from the same illness, while the risk is even greater in identical twins.
Environmental factors: Factors like stress, drug abuse, drinking problem, domestic violence, abusive childhoods and major life events can also trigger psychosis.
Psychosocial factors: Those already suffering from other mental health issues like anxiety disorder, depression or bipolar disorder have an increased risk of suffering from psychosis.
SYMPTOMS
The symptoms of psychotic disorders include:
- Delusions
- Hallucinations
- Disorganized thought and speech
- Behavioural disturbances
- Disturbed motor movements
These symptoms can be accompanied by loss of motivation, loss of interest in activities and social withdrawal.
Apart from the generalized symptoms, Dr Parikh highlights behavioural changes in people suffering from psychotic disorder. ‘Hallucinations and delusional behaviour at times lead to a heightened sense of fear in some patients. In some cases, the condition affects their thoughts to such an extent that they are unable to speak or express their thoughts in the right manner. They may withdraw from their friends and family, preferring to stay alone. Their personal hygiene may suffer as well. Such disorders tend to affect both one’s social life as well as one’s professional functioning. Unfortunately, individuals suffering from mental illness are additionally straddled with stigma and discrimination, thus making recovery that much more difficult,’ he says.
DIAGNOSIS
‘There are no laboratory tests that can help diagnose psychotic disorder at present. It is therefore diagnosed through a clinical interview with a psychiatrist, and may at times require a psychodiagnostic evaluation conducted by a clinical psychologist, ‘explains Dr Parikh. The psychodiagnostic evaluation involves analysis of family history and the psychological state of the patient. Sometimes, medical tests may be conducted to rule out other conditions associated with similar symptoms.
TREATMENT
Psychotic disorders cannot be cured. Treatment approaches are aimed at controlling symptoms and help patients live a satisfying life.
Medication: ‘Psychotic disorders are caused due to an imbalance of neurotransmitters in the system, and therefore the treatment involves medications as directed by a psychiatrist,’ says Dr Parikh. Antipsychotic medications like chlorpromazine and trifluoperazine work by helping the chemical imbalance restore. They effectively treat acute psychotic disorder and prevent future episodes of the disorder. Psychotic disorders triggered due to an underlying medical condition like depression are treated with medication for underlying condition.
Rehabilitation: Those suffering from psychotic disorders caused due to alcoholism or substance abuse may benefit more from rehabilitation and medical help to quit the habit apart from medication therapy alone.
Counseling and behavioural therapy: Counseling can go a long way in reducing symptoms in patients with psychotic disorders. It offers support not only to the patients but also to their family members. Once a patient’s health has improved, counseling and behavior therapy can also help the individual challenge their dysfunctional thoughts and adapt to the requirements of day to day living. It’s important to remember that a positive home environment can play a significant role in the recovery of such conditions, and so family therapy may also be beneficial.
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