Abstract
Psychosis is a syndrome characterized by features of reality distortion such as delusions and hallucinations. It may occur as a primary mental disorder or secondary to a medical or neurological illness or substance abuse. Several genetic, environmental, and protective risk factors have been identified and require further study. Neurobiological damage at the onset of schizophrenia is the most active and destructive. Therefore, it is important to detect the prodromal phase of psychosis so that interventions can be started early and the onset of psychosis delayed. Herein, we review the relevant epidemiological data on psychosis, particularly in Saudi Arabia. In addition, the risk and protective factors of psychosis will be discussed.Recent findings have shown that psychosis development is affected by genetic and environmental factors. Psychotic disorders are considered a cause of disability and are, therefore, a substantial economic burden. Consequently, it is important to try and detect the psychosis in its prodromal stage, where intervention may slow its progression and improve general wellbeing. Several tools have been identified to screen for the prodrome of psychosis, one of which is the prodromal questionnaire-brief version. This has been shown to be a promising tool that can be self-administered by the patient in contrast to long interview-based tools, which are time-consuming and require a physician to perform. Despite the limited evidence in the literature, there have been significant improvements in the outcomes of patients with psychosis when treated in the prodromal period.In summary, this article provides psychiatrists and researchers with an overview of psychosis, its risk factors, the prodromal stage of psychosis, tools to detect the prodromal phase, and potential treatments during this phase.
Highlights
BackgroundPsychotic disorders are characterized by a disconnection from reality
Psychosis by itself is a syndrome rather than an illness, and it is defined as "the experience of loss of contact with reality that is not part of the person's cultural or religious beliefs." Psychosis is a sign of mental illnesses that is a diagnosis of exclusion after ruling out secondary causes, such as substance abuse and other illnesses, which might lead to psychosis such as stroke, some types of epilepsy, and brain tumors
Thereby, several tools were created to detect the prodromal stage of psychosis, which is defined as preliminary signs and symptoms that do not fulfill the characteristic criteria of the disease [5]
Summary
Psychotic disorders are characterized by a disconnection from reality. Psychosis by itself is a syndrome rather than an illness, and it is defined as "the experience of loss of contact with reality that is not part of the person's cultural or religious beliefs." Psychosis is a sign of mental illnesses that is a diagnosis of exclusion after ruling out secondary causes, such as substance abuse (marijuana) and other illnesses, which might lead to psychosis such as stroke, some types of epilepsy, and brain tumors. A relatively specific association between a common variation in GABA receptor genes and the occurrence of rare copy number variants (CNVs) has been shown to be increased in schizophrenic patients as compared with controls [33] Establishing such genetic associations with psychosis is vital as those high-risk SNPs may be used as biomarkers for screening UHR individuals and identifying them earlier. The risk factors of psychosis were divided based on their onset of assessment into (1) baseline risk factors, which could be assessed throughout the life of the individual and include (a) genetic profile, as a person who has a first-degree relative with psychosis has an increased risk for psychosis and psychotic disorders, and (b) the sex of an individual, as males have an increased risk; (2) distal risk factors that are assessed distally to the onset of illness such as (a) abnormal fetal environment and (b) abnormal cognitive development; proximal risk factors that are assessed proximally to the onset of illness and include: (a) prodromal psychotic symptoms, (b) biomarkers such as elevated dopamine levels in the brain and decreased cortical size, which can be assessed using modern neuroimaging techniques [38].
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