Section 1:
Psychosis
The American Psychological Association (APA) and World Health Organization (WHO) have developed a clear definition of psychosis. They define psychosis as the presence of auditory and or visual hallucinations, delusions, and disorganized speech. Even though this definition is limited it serves as a differential diagnosis.
The Stigma of Mental Health Disorders
The Oxford Dictionary describes mental health as: “A person’s condition concerning their psychological and emotional well-being.”
People with mental disorders are at an elevated risk of stigma, which leads to adverse outcomes in life. Stigma can result in substantial barriers to an individual’s pursuit of healthcare, housing, and vocational goals.
Psychosis Overview


Psychotic Symptoms
Hallucinations


Delusions
Diagnosis of Psychosis
The diagnosis of psychosis should entail a thorough medical workup, psychiatric consultation along with an evaluation of the patient’s bio-psychosocial history and presenting symptoms. Information noted in the Diagnostic and Statistical Manual of Mental Disorders, DSM-5 can aid in the diagnosis of psychosis, including symptomology of hallucinations, delusions, disorganized speech, negative symptoms, and abnormal motor behavior.
It is important to note that a person’s display of emotional and behavioral dysregulation may or may not be a sign of an internal disease process with a singular biological answer. Empirical research indicating a specific relational roadway between biological disruption and disease process arguably has merit; however, it may fall short in recognizing that such relational pathways do not, and most often cannot, abide concerning a person’s feelings, emotions, and behaviors.


Alternative Viewpoints
The American Psychiatric Association Diagnostic and Statistical Manual of Mental Disorders (DSM-5) is one of the current diagnostic manual’s clinicians utilize to determine diagnoses. The DSM-5 classification of psychotic disorders indicates that this disorder develops along a spectrum with two extreme ends. At one end is Schizotypal personality disorder, including mild symptoms of psychosis. At the other end is Schizophrenia, which illuminates the severity of the condition.
The Power Threat Meaning Framework is a non-diagnostic conceptual framework system developed by members of The British Psychological Society. This diathesis-stress model understands an alternative etiology of psychosis suggesting that some psychiatric symptoms may be logical reactions to experiencing an environment of extreme stressors, and these rational reactions, both activated and socially guided, serve a protective role and illustrate a person’s capacity for purpose-making and meaning. Diagnosis in practice is, at its fundamental core, a striving to make sense of symptomology, to make sense of what is wrong with a patient and how to assist them through researching empirical data, looking at recurrent themes and patterns in the human body’s function and dysfunction. A diagnosis is limited in identifying emotional and behavioral symptoms because it is based on theoretical systems for figuring out our bodily dysregulation rather than feelings, emotions, and behaviors.
Misunderstood Diagnosis
Many factors contribute to misdiagnosed or misunderstood physiological conditions. Many factors can make people experience hallucinations. In some cases of severe post-partum depression, psychotic features may be present. Recreational and some prescription medications can make people see or hear things that are not there. The first factor is that an accurate diagnosis depends on a thorough history-taking and a specific inventory of ongoing, current symptomology. Additionally, there is a significant overlap of symptoms among disorders, and the instability of the symptoms of these disorders is essential, especially when they involve hallucinations and or delusions. Many factors can make people experience hallucinations.
Recreational and some prescription drugs can make people hear or see things that are not real. In some situations, this can lead to a false diagnosis. Furthermore, the limited knowledge and experience of the professionals conducting assessments can also contribute to misdiagnoses.


Treatments of Psychosis
- Pharmacological Intervention: Medication-assisted treatment is one of the primary interventions for patients with psychosis features. However, antipsychotic medications are often prescribed as the only therapy rather than as part of a combination. Pill form along with long lasting injectable types of the medicine risperidone have been found effective in combat veterans with PTSD symptoms and psychotic symptoms. Risperidone has been found effective in combat veterans with PTSD symptoms and psychotic features. Veterans treated with risperidone recorded a significant reduction in psychotic features, as indicated by their Positive and Negative Syndrome Scale (PANSS) scores. Despite the potential effectiveness of medication-assisted interventions for psychotic symptoms, the literature suggests that clinicians should be careful when prescribing medications. Even though pharmacological treatment may improve outcomes for individuals with psychosis features, the action components for certain antipsychotic drugs remain unclear.
- CBT Interventions: Cognitive behavior therapy (CBT) is among the most significant alternative interventions for psychosis. Many of the components essential for CBT are generic. They can be applied to most other forms of psychotherapy, such as collaboration, a good therapeutic relationship, and the need for a therapy structure. CBT for psychosis (CBTp) is an evidence-based treatment modality with reliable and acceptable evidence for decreasing psychotic features and mood variances. It addresses a wide variety of problems, focusing on reducing symptoms, leading to a reduction in hospitalizations and the distress associated with experiencing anxiety and psychosis.
- Group Interventions: Group modalities tend to have more positive results based on identifying and validating feelings, social interaction, and identification for people who are alone and isolated. They can increase their self-esteem by supporting one another in the group. They are also cost-effective. Psychotic disorders have been negatively associated with significant financial burdens on society, highlighting the need for less expensive treatment modalities. Cognitive-behavioral group intervention has the potential to meet patients' needs while decreasing the financial burden on the healthcare system as a whole. They can increase their self- esteem by supporting one another in the group, and once stabilized they can continue to foster community connection by ongoing attendance.
- Cultural perspectives & interventions: Spiritual Shaman or healers often use traditional and alternative interventions for mental health problems. Traditional healers and their patients share the same cultural norms and socio-economic value systems. Some conventional healers adopt an integrated approach, integrating social, physical, spiritual, and psychological methods. Traditional healers are also more available and accessible than modern medical staff in developing nations. These advantages do not suggest that traditional healing is always recommended because it raises many ethical, human rights, and dignity issues.
- Therapeutic Alliance: The therapeutic alliance measures mutual cohesive engagement by both therapist and client. It is another integral element for improving patient outcomes, as such alliance is linked to better conditions at discharge, even though it is unclear precisely how it leads to better patient outcomes. A good alliance is considered essential for psychological health and the capacity to cooperate in mutually gratifying ways. This results in enhanced outcomes for the patient. It should be practiced with all treatment modalities.