Saturday, December 8, 2007

What IS a “Psychotic Disorder", Anyway?

Following up on the question Is Schizophrenia a “Psychotic Disorder”, if neurodevelopmental, genetic and medical problems resulting in psychosis are not "psychotic disorders"... then what really IS a "psychotic disorder?"

I tried looking up "psychotic disorder" and did not find a real definition.

One source defined it by example using the schizophrenias.... the same set of illnesses that actual researchers are saying probably should not be considered a "psychotic disorder" since the psychosis is just one symptom of the illness, and a probable secondary one at that.

So why has schizophrenia historically been considered a psychotic disorder?

Because it historically has been viewed to be a product of a person's MIND (mental) rather than consisting of symptoms arising from a problem affecting the BRAIN (physical/medical). Many genetic illnesses causing psychosis are not called "psychotic disorders," let alone “schizophrenia.”

Part of the criteria for diagnosing "schizophrenia" is not having another medical label to which to attribute the symptoms. IF they find a medical cause for it -- then it is not "schizophrenia."

BUT, the same symptoms can still be labeled a “psychotic disorder due to a general medical condition” for the purposes of communication among professionals, even though it wasn’t meant to imply that it is actually due to some “emotional” or “mental” etiology.

Part of the diagnostic criteria for the label "schizophrenia" EXCLUDES symptoms from a “general medical condition”. Therefore, by definition, schizophrenia is NOT from a known medical condition. Therefore, schizophrenia has been assumed to be "mental". And since psychosis is its most floridly salient feature, schizophrenia has been the poster child for "psychotic disorder."

The bottom line apparently is that a “psychotic disorder” is a non-purely genetic illness that has hallucinations and delusions as its most prominent feature.

The point Nasrallah and other researchers are making[1] is that the primary problem in “schizophrenia” is NOT the hallucinations and delusions, but rather some deterioration causing problems in the FUNCTION of the brain.  This deterioration of the brain's ability to function may then result in symptoms of psychosis as a secondary effect.  

[1] "Is Schizophrenia a Psychotic Disorder?Current Psychiatry online Vol. 6, No. 12 / December 2007); and    Is Schizophrenia a Psychotic Illness?

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Last Updated: 1 November 2011

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