Schizophrenia Spectrum and Psychotic Disorders
In these disorders the main symptomatology observed is the presence of psychosis which is a loss of touch with reality. This can be associated with paranoia, disorganized speech and behaviors. Thinking process is also disrupted.
Treating psychosis in senior patients can be challenging as it can be caused by a wide variety of factors. Understanding the source of the psychosis will help us to take the appropriate steps to treat the underlying cause that in most situations is reversible.
Psychosis can be caused by Urinary Tract infections (UTI) which is a very common clinical picture. Decompensation of chronic medical illnesses as Hypertension and Diabetes are potential causes. Neurological disorders are very common in the differential diagnosis as well. Medications side effects are a common diagnosis that needs to be ruled out.
After completing blood work, brain imaging if needed, and other testing, we rule out secondary causes of psychosis. Once secondary causes are ruled out, we proceed to establish diagnosis of Primary Psychotic Disorders such as Schizophrenia or Schizoaffective Disorders.
Some other psychiatric disorder that present with psychosis include Major Depression, Bipolar Disorder, and Dementia amongst others.
Early treatment is of paramount importance as it improves the long term prognosis.