Acute psychosis in adolescents

[ad_1]

What is it about ?

Acute psychosis is a mental state in which a person completely or partially loses normal contact with reality. The symptoms can be diverse and varied. The adjective “acute” means that the symptoms appear suddenly. The main ones psychotic symptoms

can occur separately or at the same time.

Delusions

Delusions are stubborn thoughts or ideas, about yourself or those around you, which do not correspond to reality. The person with psychosis does not question these delusions; she is not able to tell the difference between what is real and what is not. There are different types of delusions, such as:

  • The delusion of persecution, when the person thinks he is being followed constantly or being the object of a conspiracy;
  • Delirium of grandeur (or delusional megalomania), when the person thinks they are an important religious figure (Christ, for example) or a famous person (Napoleon, for example).
HALLUCINATIONS

The person can also perceive (hear, see, smell, feel …) things that are not there. This is what we call hallucinations. The most common hallucinations are auditory (the person hears voices) and visual (the person sees imaginary people).

CONFUSION

A third characteristic symptom of psychosis is the confusion : the person is not able to hold a coherent speech or suddenly forgets what he was doing.

CAUSES OF ACUTE PSYCHOSIS
  • Acute psychosis can be a condition in its own right or part of a larger, complex psychiatric problem.
  • It can also be the consequence of physical illness, taking certain medications or withdrawal symptoms (for example after excessive drug or alcohol use).
  • Likewise, a severe lack of sleep can trigger or worsen psychotic symptoms, as theinsomnia often leads to (over) stimulation of the senses and false perceptions.

Acute psychosis can scare close relatives and friends of the person in question. All the more so when it comes to a first period of psychosis.

How to recognize it?

Be vigilant when a teenager changes their behavior. This is often the first sign that suggests psychosis. The first signs of the disease are also known as “prodromes” (symptoms of the onset of an illness or an acute attack). They are difficult to recognize, especially in adolescents, in whom it is not easy to differentiate “normal” behavior during puberty from an underlying psychological problem. The prodromes can therefore only be confirmed after the fact. Here are some examples of prodromes:

  • Anxiety;
  • Depression, mood swings, irritability;
  • Lack of emotion, motivation, enthusiasm;
  • Concentration disorders;
  • Sleeping troubles ;
  • Decreased functioning, breakdown of relationships;
  • Altered perception of forms, space and sounds, mistrust.

Not all people who present with prodromes develop psychosis, far from it. The risk of psychosis is particularly marked in young people who have a psychotic direct parent and who themselves present psychological symptoms associated with reduced performance.

Schizophrenia
People with schizophrenia suffer from persistent or recurrent psychosis.
With psychosis, both positive and negative symptoms are possible.

  • Sometimes people with psychosis have exceptional experiences and notice extraordinary things (positive symptoms). They suffer from hallucinations and delusions, or are confused.
  • During the interval between episodes of psychosis, people with schizophrenia also don’t function like everyone else. They often have less energy, are passive, let go, lose contact with their friends, are centered on themselves and feel empty and sad. These are negative symptoms.

In an adolescent, the diagnosis of schizophrenia can only be made after one year of follow-up.

Affective disorder (or bipolar disorder)
Affective disorder is sometimes accompanied by psychoses characterized not only by delusions and hallucinations, but especially by mood and emotional disturbances. It is then a question of manic and depressive psychoses.

Symptoms of depression are as follows:

  • Fatigue, lack of energy,
  • Changes in sleeping habits,
  • Irritability, hostility,
  • Isolation, melancholy,
  • Physical exhaustion,
  • Feelings of worthlessness,
  • Feelings of guilt and remorse,
  • Despair,
  • Thoughts of suicide and suicide attempts.

Rather, the manic symptoms are as follows:

  • Euphoria,
  • Hyperactivity,
  • Overflowing sexual activity,
  • Irritability, aggressiveness,
  • Physical symptoms: eating too much, sweating.

Organic psychosis
A psychosis is said to be “organic” when it is clearly due to a physical cause. Most of the time, it is about substance abuse. Suddenly using or stopping drugs or alcohol can lead to psychosis. Some drugs are even used expressly to trigger hallucinations (LSD, hallucinogenic mushrooms). In this case, the consumer is generally aware that it is the drugs that cause the hallucinations. There is therefore no question of psychosis. On the other hand, people who are genetically predisposed to it can develop psychosis when they use cannabis. A tumor in the brain, epilepsy, bleeding in the brain and an inflammation of the brain (encephalitis) can also cause psychosis.

How is the diagnosis made?

The general practitioner may suspect psychosis in a teenager who has changed behavior such as decreased functioning or destructive behavior. In this case, he may ask questions about the presence of psychotic symptoms. If the answers confirm his suspicion, he can refer the teenager to a psychiatrist for further examinations.

What can you do ?

When faced with a change in adolescent behavior, it is important to remain vigilant and seek medical help without delay when the situation threatens to escalate. In certain emergency situations, it is sometimes necessary to place the young person as quickly as possible in a specialized and protected environment.

What can your doctor do?

Psychosis in adolescents is a specific problem that requires psychiatric treatment. The general practitioner will therefore refer you to a psychiatrist or, in severe cases, will request hospitalization. In certain very serious situations, he may find it necessary to have recourse to a mobile crisis team. This team intervenes urgently at home for a short time. Your general practitioner will be able to provide you with more information on this subject.

Long-term treatment is intensive, takes a long time and combines drug treatment with psychotherapeutic follow-up. The goal of treatment is to allow the adolescent to return to functioning as normal as possible and to avoid relapses. Its success depends on a good network of care, tailor-made for young people with psychosis and involving their family and those around them. If it is also a question of drug, alcohol or other substance abuse, this problem must also be taken care of.

Source

Foreign clinical practice guide ‘Psychosis in adolescents’ (2000), updated on 23.08.2017 and adapted to the Belgian context on 05.11.2019 – ebpracticenet

[ad_2]

Latest