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Psychosis: Schizophrenia
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A psychosis is a major psychiatric disorder characterized by the inability to tell what is real from what is not real. Hallucinations, delusions, and thought disorders can accompany psychosis. People who are psychotic often have a difficult time communicating with or relating to others. Sometimes they become agitated and violent. Among the conditions that include symptoms of psychosis are schizophrenia and manic depression (... known as bipolar disorder).
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Next, Dr. Fenton discusses what's going on in the brain during psychosis. He says there is evidence that psychosis springs from a defect in the brain's filtering system, probably located in the thalamus, which distorts the mind's ability to determine whether information is coming from inside the body or from an outside source. The neurotransmitter dopamine appears to be involved; in fact, psychoses arising from met amphetamine or cocaine abuse can be treated successfully with agents that block dopamine. Those same agents are ... effective in treating psychosis in schizophrenia and manic depressive illness, he says.
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When determining the cause of psychosis, a doctor will take a careful history. It is important for the doctor to determine whether psychosis is the result of a psychiatric illness such as schizophrenia, or whether it is secondary to an underlying medical problem. Because the patient may not be able to communicate reliably, relatives and friends should accompany the patient to the doctorÂ’s office to provide accurate information.
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According to the DSM, psychosis can be a symptom of mental illness, but it is not a mental illness in its own right. For example, people with schizophrenia often experience psychosis, but so can people with bipolar disorder (manic depression), unipolar depression, delirium, or drug withdrawal.[8][2] People diagnosed with these conditions can ... have long periods without psychosis. Conversely, psychosis can occur in people who do not have chronic mental illness (e.g. due to an adverse drug reaction or extreme stress).[9]
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The categorical view of psychosis is most associated with Emil Kraepelin, who created criteria for the medical diagnosis and classification of different forms of psychotic illness. Particularly, he made the distinction between dementia praecox (now called schizophrenia), manic depressive insanity and non-psychotic states. Modern diagnostic systems used in psychiatry (such as the DSM) maintain this categorical view.
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The treatment approach to psychosis in epilepsy depends on the etiology of the symptoms and whether the psychosis is the sustained interictal type. Symptoms limited to the postictal period may remit spontaneously, although antipsychotic medication at low doses is often required. A schizophrenia-like
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