What is defined as a psychotic disorder characterized by significant disturbances in thought and emotion?

Mental illness is a general term for a group of illnesses that may include symptoms that can affect a person’s thinking, perceptions, mood or behaviour. Mental illness can make it difficult for someone to cope with work, relationships and other demands. The relationship between stress and mental illness is complex, but it is known that stress can worsen an episode of mental illness. Most people can manage their mental illness with medication, counselling or both.This page lists some of the more common mental health issues and mental illnesses.

Anxiety disorders

Anxiety disorders is a group of mental health disorders that includes generalised anxiety disorders, social phobias, specific phobias (for example, agoraphobia and claustrophobia), panic disorders, obsessive compulsive disorder (OCD) and post-traumatic stress disorder. Untreated, anxiety disorders can lead to significant impairment on people’s daily lives.

For more information see: Anxiety disorders.

Behavioural and emotional disorders in children

Common behaviour disorders in children include oppositional defiant disorder (ODD), conduct disorder (CD) and attention deficit hyperactivity disorder (ADHD). Treatment for these mental health disorders can include therapy, education and medication.

For more information see: Behavioural disorders in children.

Bipolar affective disorder

Bipolar affective disorder is a type of mood disorder, previously referred to as ‘manic depression’. A person with bipolar disorder experiences episodes of mania (elation) and depression. The person may or may not experience psychotic symptoms. The exact cause is unknown, but a genetic predisposition has been clearly established. Environmental stressors can also trigger episodes of this mental illness.

For more information see: Bipolar disorder.

Depression

Depression is a mood disorder characterised by lowering of mood, loss of interest and enjoyment, and reduced energy. It is not just feeling sad. There are different types and symptoms of depression. There are varying levels of severity and symptoms related to depression. Symptoms of depression can lead to increased risk of suicidal thoughts or behaviours.

For more information see: Depression.

Dissociation and dissociative disorders

Dissociation is a mental process where a person disconnects from their thoughts, feelings, memories or sense of identity. Dissociative disorders include dissociative amnesia, dissociative fugue, depersonalisation disorder and dissociative identity disorder.

For more information see: Dissociation and dissociative disorders.

Eating disorders

Eating disorders include anorexia, bulimia nervosa and other binge eating disorders. Eating disorders affect females and males and can have serious psychological and physical consequences.

For more information see: Eating disorders.

Obsessive compulsive disorder

Obsessive compulsive disorder (OCD) is an anxiety disorder. Obsessions are recurrent thoughts, images or impulses that are intrusive and unwanted. Compulsions are time-consuming and distressing repetitive rituals. Ttreatments include cognitive behaviour therapy (CBT), and medications

For more information see: Obsessive compulsive disorder.

Paranoia

Paranoia is the irrational and persistent feeling that people are ‘out to get you’. Paranoia may be a symptom of conditions including paranoid personality disorder, delusional (paranoid) disorder and schizophrenia. Treatment for paranoiainclude medications and psychological support.

For more information see: Paranoia.

Post-traumatic stress disorder

Post-traumatic stress disorder (PTSD) is a mental health condition that can develop as a response to people who have experienced any traumatic event. This can be a car or other serious accident, physical or sexual assault, war-related events or torture, or natural disasters such as bushfires or floods.

For more information see: Post-traumatic stress disorder.

Psychosis

People affected by psychosis can experience delusions, hallucinations and confused thinking.. Psychosis can occur in a number of mental illnesses, including drug-induced psychosis, schizophrenia and mood disorders. Medication and psychological support can relieve, or even eliminate, psychotic symptoms.

For more information see: Psychosis.

Schizophrenia

Schizophrenia is a complex psychotic disorder characterised by disruptions to thinking and emotions, and a distorted perception of reality. Symptoms of schizophrenia vary widely but may include hallucinations, delusions, thought disorder, social withdrawal, lack of motivation and impaired thinking and memory. People with schizophrenia have a high risk of suicide. Schizophrenia is not a split personality.

For more information see: Schizophrenia.

Where to get help

• Your GP (doctor)
• Mental health services

Psychotic disorders or episodes arise when a person experiences a significantly altered or distorted perception of reality. Such distortions are often caused or triggered by hallucinations (false perceptions), delusions (false beliefs) and/or disrupted or disorganised thinking. Psychotic disorders are relatively common in young people, with around two in every 100 young adults experiencing some form of psychotic episode.

Signs this might be a problem:

• withdrawal from family and friends
• inability to maintain employment or engage in studies
• confusion
• confused speech
• inappropriate or erratic behaviour and reactions
• hearing voices when alone or that others cannot hear
• mood swings.

Psychosis is characterised by some sense of distorted reality. A psychotic episode may include many so-called 'positive symptoms; which include:

• Hallucinations: seeing, hearing, feeling sensations that are not actually occurring
• Delusions: believing in false realities, such as having superpowers. Delusions may be also paranoid beliefs, such as thinking you're being watched or followed
• Thought disorder: characterized by jumbled or disorganised thoughts.

Negative symptoms include: Depressed or flattened mood. Difficulty engaging in conversation, such as difficulty following others or putting sentences together coherently, or engaging in unprompted or indirect speech.

Psychotic symptoms can be due to a psychotic disorder, but can also be caused by some drugs and prescription medications, or occasionally by medical conditions.

What are psychotic disorders?

Psychotic disorders cover a range of disorders and have a range of associated symptoms. Essentially psychotic disorders are those which involve some form of altered/distorted perception of reality that is persistent for a considerable period of time and interferes with daily functioning. As many as three in every 100 people will experience some form of a psychotic episode during their lifetime, and the first experience of psychosis most commonly occurs between the ages of 15-30 years.

Psychotic episodes can occur as an isolated event but are frequently an indication/symptom of an underlying psychotic disorder or mental health problem. Although psychotic disorders are not entirely understood, some risk factors associated include; a family history of psychotic disorders or episodes (especially schizophrenia) and drug use, specifically hallucinogenic drugs, amphetamines and cannabis. Stressful life events may trigger the onset of a psychotic episode.
The most common psychotic disorders include:

Schizophrenia

Schizophrenia is a psychotic illness that is considered present when a person suffers psychiatric symptoms (such as hallucinations or delusions) for at least six months (with two or more symptoms present for much of the time over a one month period), with changes in behaviour and interference in daily functioning (e.g. work or education commitments) occurring as a result.

Diagnosis is often complicated because the symptoms experienced can be present in other disorders, and the extent of the symptoms may not be communicated (e.g. people may not want to confide in anyone that they are hearing voices for fear of stigmatisation, or due to paranoid delusions and mistrust of doctors etc).

Schizophreniform is similar to schizophrenia, only the symptoms have not persisted for six months. Schizoaffective disorder is diagnosed when a person is experiencing symptoms of psychosis and schizophrenia and another mood disorder.

Bipolar disorder

Bipolar is an affective disorder characterised by intense mood swings. People with bipolar often have intense highs (mania or hypomania) which are followed by intense lows (depression or major depressive episode). Not all people with bipolar will experience psychotic symptoms, but some will during the episodes of mania or depression. People in manic episodes may have extreme grandiose feelings, or believe they have unrealistic abilities (such as a guaranteed win in the lottery).

Major depression with psychotic features

Psychotic depression may be present when clinical depression presents with symptoms of psychosis. This is relatively uncommon and typically only occurs with severe depression.

What students can do about psychosis

For most people, psychosis can be treated and psychotic disorders can be managed to minimise the occurrence of psychotic episodes. Discussing the situation with a trusted teacher, parent, counsellor or local GP (who can refer to a psychiatrist, if necessary) is an important first step for students worried about psychosis, either for themselves or a friend or relative.

Early treatment for psychosis and psychotic disorders is associated with better treatment outcomes and recovery. Upon consultation with a psychiatrist or GP, medication may be considered the most appropriate course of action, especially if diagnosed with schizophrenia and major depression with psychotic features. Other treatments may involve counselling, education programs focusing on raising awareness about the signs and symptoms associated with psychotic disorders so that they can be recognised at their very onset.

Given stress may trigger a psychotic episode, minimising stress and enhancing coping strategies may be helpful. For people with bipolar, establishing regular sleeping patterns can minimise the onset and/or severity of mood swings and consequently psychotic features. Avoiding drugs, particularly hallucinogenic drugs, cannabis and amphetamines is especially important for people with a history of psychosis.

ReachOut.com resources on psychotic disorders

Recommended professional resources

Orygen Youth Health has excellent resources for understanding young people with psychosis and how to help. We recommend: