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Clearing Up Confusion About Schizophrenia Vs Psychosis



Psychosis can affect people from all walks of life. Psychosis often begins when a person is in his or her late teens to mid-twenties. There are about 100,000 new cases of psychosis each year in the U.S.


There is no one specific cause of psychosis. Psychosis may be a symptom of a mental illness, such as schizophrenia or bipolar disorder. However, a person may experience psychosis and never be diagnosed with schizophrenia or any other mental disorder. There are other causes, such as sleep deprivation, general medical conditions, certain prescription medications, and the misuse of alcohol or other drugs, such as marijuana. A mental illness, such as schizophrenia, is typically diagnosed by excluding all of these other causes of psychosis. To receive a thorough assessment and accurate diagnosis, visit a qualified health care professional (such as a psychologist, psychiatrist, or social worker).




Clearing up Confusion about Schizophrenia vs Psychosis



Myxedematous psychosis may happen when your thyroid gland doesn't work well, known as hypothyroidism. Because of the way thyroid hormone affects your brain, you may have hallucinations, delusions, and changes to your sense of taste or smell if there's not enough in your body. Your doctor can test your level of thyroid-stimulating hormone (TSH) to confirm myxedema psychosis and rule out other conditions like schizophrenia.


More modest but still significant results have been obtained in population-based samples. A recent study from Ireland found that 8 of 159 patients with male-to-female gender dysphoria (5%) had comorbid schizophrenia, as opposed to none of 59 patients with female-to-male GD [7]. Psychiatric evaluation of 230 self-referred applicants for gender-reassignment surgery in Spain, after excluding patients with psychosis but no clear diagnosis of GD/GID, identified six cases (2.6%) of psychosis, with equal rates in male and female subjects [13]. Though these figures are lower than those of the referral-based studies, they are likely to be closer to the true prevalence in this population and are still far higher than would be expected by chance alone. A study of Taiwanese students which measured symptoms, rather than diagnoses, found a strong correlation between symptoms of GID and schizophrenia in male students [14], also suggesting an effect of gender on this association.


Many people with schizophrenia withdraw from the outside world, act out in confusion and fear, and are at an increased risk of attempting suicide, especially during psychotic episodes, periods of depression, and in the first six months after starting treatment.


While schizophrenia is a chronic disorder, many fears about the disorder are not based in reality. Most people with schizophrenia get better over time, not worse. Treatment options are improving all the time and there are plenty of things you can do to manage the disorder.


Seek social support. Friends and family vital to helping you get the right treatment and keeping your symptoms under control. Regularly connecting with others face-to-face is also the most effective way to calm your nervous system and relieve stress. Stay involved with others by continuing your work or education. If that's not possible, consider volunteering, joining a schizophrenia support group, or taking a class or joining a club to spend time with people who have common interests. As well as keeping you socially connected, it can help you feel good about yourself.


While schizophrenia runs in families, about 60% of schizophrenics have no family members with the disorder. Furthermore, individuals who are genetically predisposed to schizophrenia don't always develop the disease, which shows that biology is not destiny.


While these dangers are well known, alcohol-induced psychosis is another problem that you may not be as familiar with. At Banyan Mental Health, we are a dual diagnosis treatment center that works with people who experience psychosis associated with alcohol, and we want to clear up some of the confusion.


Still, some researchers are convinced that marijuana contributes to the development of schizophrenia. There have been nine studies following hundreds to thousands of people for decades looking for a connection between marijuana use and psychosis.


"But what is also clear, if you do have a vulnerability to schizophrenia and you smoke [cannabis]," Volkow says, "it's likely to trigger an episode. It's likely to advance the [disease]." She says when people with certain risky genes associated with psychosis smoke, the risk of developing schizophrenia goes up sixfold, according to a 2005 study. But for someone without those genes, Volkow says the evidence suggests "you can smoke all the marijuana you want and it will make no difference whatsoever."


Murray says that only strengthens the case that cannabis increases the risk for schizophrenia. A recent study he published in The Lancet suggests that abusing marijuana with around 15 percent THC content, which is common among growers today, could quintuple the risk for schizophrenia. "We think about 5 percent of people will go psychotic instead of 1 percent. That [still] means over 90 percent of people who smoke the high-potency will be OK," he says.


Objective: Patients with narcolepsy often experience pervasive hypnagogic hallucinations, sometimes even leading to confusion with schizophrenia. We aimed to provide a detailed qualitative description of hypnagogic hallucinations and other "psychotic" symptoms in patients with narcolepsy and contrast these with schizophrenia patients and healthy controls. We also compared the prevalence of formal psychotic disorders between narcolepsy patients and controls.


Autism and schizophrenia share a convoluted history. Before autism had its own entry in the Diagnostic and Statistical Manual of Mental Disorders, people with autism were diagnosed with childhood-onset schizophrenia. When autism finally got its own category in 1980, the criteria prohibited dual diagnoses of autism and schizophrenia, perhaps to steer clear of the previous confusion.


Last month, we received an email from a mother who was seeking help for her 15-year-old son. Diagnosed with autism in preschool, he had become increasingly disengaged, caught up in his own thoughts and paranoid. Though he had always struggled socially and with conversation, his verbalizations were making less and less sense. He was talking to himself, yelling back to the apparent voices in his head. He was constantly agitated. The mother asked us what we knew about treatment of psychosis in autism.


Among 30 women suffering from a postpartum psychosis without affective syndrome, and for whom this episode of illness was the first leading to psychiatric hospitalisation, 19 fulfilled in the long-term course the DSM-III-R criteria for schizophreniform psychosis (SCHF) or brief reactive psychosis (BRP), and 11 fulfilled the criteria for schizophrenia (SCH). The two groups were compared in order to investigate their nosological relation. Patients with SCHF or BRP more often had the symptomatology of cycloid psychoses and signs of confusion, the onset of illness was more frequently abrupt and the age at the index delivery tended to be lower (p


We are still learning about how and why psychosis develops, but several factors are likely involved. We do know that teenagers and young adults are at increased risk of experiencing an episode of psychosis because of hormonal changes in their brain during puberty.


In chronic alcoholic patients, lack of thiamine is a common condition. Thiamine deficiency is known to lead to Wernicke-Korsakoff syndrome, which is characterized by neurological findings on examination and a confusional-apathetic state. Korsakoff psychosis (or Korsakoff amnesic- or amnesic-confabulatory state) refers to a state that memory and learning are affected out of proportion to other cognitive functions in an otherwise alert and responsive patient. [4]


Alcohol-related psychosis spontaneously clears with discontinuation of alcohol use and may resume during repeated alcohol exposure. Distinguishing alcohol-related psychosis from schizophrenia or other primary psychotic disorders through clinical presentation often is difficult. It is generally accepted that alcohol-related psychosis remits with abstinence, unlike schizophrenia. If persistent psychosis develops, diagnostic confusion can result. Comorbid psychotic disorders (eg, schizophrenia spectrum and other psychotic disorders) and severe mood disorder with psychosis may exist, resulting in the psychosis being attributed to the wrong etiology.


Some characteristics that may help differentiate alcohol-induced psychosis from schizophrenia are that alcohol-induced psychosis shows later onset of psychosis, higher levels of depressive and anxiety symptoms, fewer negative and disorganized symptoms, better insight and judgment towards psychotic symptoms, and less functional impairment. [5]


Alcohol-related psychosis that does not remit with abstinence may indicate undiagnosed schizophrenia or other psychotic disorders. Contrary to amphetamine-induced psychosis, alcohol-induced psychosis tends to be short-lived and is much less likely to be chronic. The use of alcohol may potentiate or initiate psychosis through kindling, a process where repetitive neurologic insult results in greater expression of the disease.


Substance abuse is a major contributing factor to the outcome and course of treatment in mentally ill patients with psychosis. The prevalence is up to 87% in those with schizophrenia and 77% in those who are bipolar, with cannabis and alcohol being the most commonly abused. [13]


Cultural influences on alcohol-related psychosis stem from cultural norms about alcohol. Irish males who traditionally drink to the point of intoxication are at higher risk, while Jewish males who traditionally shun intoxication have lower risks. Considering the relationship of thiamine to Wernicke-Korsakoff syndrome, cultures that have a low intake of thiamine and high rates of alcohol abuse also are at higher risk for the complication of Wernicke-Korsakoff syndrome. 2ff7e9595c


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