Psychotic Disorder & Schizophrenia Evaluation and Treatment in Maine and Florida

 Here are some key features of psychotic disorders & schizophrenia:

Hallucinations: Hallucinations involve perceiving things that aren’t real. This can include hearing voices, rustling, and whistling, and various other sounds when no one is speaking or creating sound (auditory hallucinations), seeing things that others cannot see (visual hallucinations), or even feeling things that don’t exist (tactile hallucinations). In most people with a psychotic disorder auditory hallucinations are the most common however, hallucinations do not need to exist in psychotic disorders and often early on ideas of reference (false beliefs that random or irrelevant occurrences in the world relate directly to oneself), overvalued ideas, or delusions occur before hallucinations.

Delusions: Delusions are strongly held false beliefs that are resistant to reason or contrary evidence. For example, a person with a psychotic disorder may believe that they have special powers or that they are being persecuted or monitored by external forces.

Disorganized Thinking: Individuals with psychotic disorders often have difficulty organizing their thoughts and may jump from one unrelated topic to another. This can include difficult to follow speech, in severe cases their speech may be incoherent.

Emotional Disturbances: Emotional responses can be inappropriate or blunted in people with psychotic disorders. They may appear emotionally flat or experience intense and unpredictable mood swings.

Social Impairment: Psychotic disorders can cause significant disruptions in social functioning. Individuals may withdraw from relationships and have difficulty forming and maintaining connections with others.

Prodromal Symptoms:

 

Often a patient developing schizophrenia, or a psychotic disorder has a period of decreased functioning that doesn’t fully meet the criteria for a psychotic disorder leading up to a first psychotic episode that may last for months or years. During this period, they may become more isolated, display less interest in activities, perhaps start using drugs or marijuana more often, have more difficulties sustaining attention or completing complex tasks, high school or college grades can worsen or performance at their jobs can be adversely impacted.

Negative Symptoms: Negative symptoms involve a reduction or absence of typical emotional responses or behaviors. These can include reduced motivation, diminished emotional expression, and difficulty in carrying out daily activities.

Diagnosis and treatment: The diagnosis and treatment of psychotic disorders typically involves a comprehensive evaluation by a psychiatrist. There are many causes of psychosis including substance intoxication, medical/neurological issues, bipolar disorder, medication overdose, extreme stress/PTSD, and more, which should be evaluated and ruled out before conclusively diagnosing a psychiatric disorder. If possible, a team-based and global approach has been shown to be the most beneficial in treatment, including medication management, psychoeducation, and therapy for both the patient and the family to improve insight and coping, social work to help with education and career prospects, and peer support for both patient and family to assist with feelings of isolation. We work with multiple first episode programs which have become available near our practice locations including in Portland, ME and Coral Gables, FL

The medications for schizophrenia and psychotic disorders have come a very long way since first introduced in the 1940s and 1950s. Significant reduction in symptoms with no or minimal side effects is often possible due to improved pharmacologic treatment options.

Early intervention and treatment can make a large difference in managing psychotic disorders, reducing hospitalizations, and improving a person’s quality of life for the patient and their loved ones. A comprehensive psychiatric evaluation is recommended at the earliest opportunity after onset of symptoms. 

Post reviewed and edited by Dr. Nicolas Sikaczowski, Board-Certified Psychiatrist.