Substance use and bullying, risk factors for psychosis

Christina Cebrian
First psychotic episode It usually appears in youth between 15 and 30 years of age. This is an important stage for personal, training, and educational development, so it is essential to pay attention to environmental risk factors that can lead to the development of psychosis.

He Dr. Roberto Rodriguez-JimenezThe head of the section of the psychiatric hospitalization unit, day hospital and emergency room at the 12 de Octubre Hospital in Madrid points to substance use, bullying and social isolation as the main risk factors. psychosis, Likewise, remember that comprehensive and early intervention of the first psychotic episode is essential to improve the prognosis and development of the disorder.

What are the typical features of psychosis and what diagnostic methods are used?
What characterizes mental disorders is the experience of an alternative reality. Patients suffering from mental disorders live in their own reality created based on their hallucinations and delusional ideas. The diagnostic methods we use are all performed by complementary tests that rule out non-psychiatric medical pathology or substance use that may justify the psychotic clinical picture.

In this case, secondary psychosis is diagnosed and it will be necessary to treat this underlying pathology or substance abuse. A clinical interview is also carried out where an adequate history is taken to confirm that symptoms of a psychological disorder are present in the patient and, in addition, allows to define the type of psychological disorder the person is suffering from. Is.

Psychotic episodes represent the most important symptoms of the disease. Between episodes, a clinic where anhedonia predominates

What happens to the patient in the first psychotic episodes? Are there any significant cognitive changes?
In psychotic episodes, there is reactivation of hallucinations and delusional ideas, as well as changes in behavior, language, etc. Psychotic episodes represent the most important symptoms of the disease.

Between episodes, the patient may become stable, then a clinical picture predominates where anhedonia (inability to experience pleasure), apathy, indifference, as well as significant cognitive dysfunction predominate. It is present even before the first psychotic episode. Comprehensive and prompt treatment of the first psychotic episodes is essential for future prognosis and development of the disorder.

There are different types of psychosis, which are the most common in counseling?
The quintessential mental disorder is schizophrenia. There are many other psychotic disorders, some closely related to schizophrenia, such as schizophreniform disorder or brief psychotic disorder, and others that fall between affective disorders and schizophrenia (such as schizoaffective disorder). We can also find long-term delusional disorders (chronic paranoia), as well as mental disorders induced by substances or non-psychiatric medical pathologies. In severe cases affective disorders, such as depression and bipolar disorder, may also be present with associated psychotic symptoms.

Cognitive-behavioral interventions are most recommended to avoid transition to psychosis in people at high risk of developing psychotic disorders.

Drug use is one of the risk factors for psychosis. What other risk factors are present?
There are many risk factors, as well as protective factors. Factors can be genetic and environmental. It will be the interaction of these factors that will determine whether or not the disorder will develop. In addition to substance use, bullying and social isolation are environmental risk factors.

What are the most effective treatments for psychosis?
Antipsychotic medications are the cornerstone of treatment for psychotic disorders. However, it is very common that the symptoms that persist between psychotic episodes do not improve much with these treatments (anhedonia, somnolence, apathy, cognitive decline). Therefore, it is believed that a comprehensive approach that includes both pharmacological, psychotherapeutic and psychosocial approaches is appropriate.

Avant-garde psychiatry is no longer emphasizing early treatment of psychotic episodes before a few years (secondary prevention), but rather trying to ensure that people who are at high risk of developing psychotic disorders do not develop them. (Prevention). Primary. Currently, cognitive-behavioral interventions are considered most recommended to avoid the transition to psychosis in people at high risk of developing psychotic disorders.

With good comprehensive treatment, many patients can live completely normal lives.

Can you live a normal life by following the treatment?
that’s how it is. Furthermore, it is essential to understand that, with good comprehensive treatment, many patients can live completely normal lives. The two basic pillars are compliance with medicinal treatment, avoidance of toxic substances and participation in necessary psychiatric/psychosocial interventions.

When talking about schizophrenia, is there a stigma in our society or a lack of training? How can this be countered?
Unfortunately, there is still a large social stigma regarding schizophrenia, mental disorders, and psychiatric pathology in general. The only way to combat it is to spread culture and science among the society. But it should be a culture and scientific spread in capital letters.

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