Understanding psychosis: diagnosis and clinical presentation (updates for clinicians)

Psychosis is understood as the brightest manifestations of mental illness, in which the patient's mental activity does not correspond to the surrounding reality, the reflection of the real world in consciousness is sharply distorted, which manifests itself in behavioral disorders, abnormal pathological symptoms and syndromes. Psychosis is a combination of biological (genetic, neuroanatomical, neurophysiological), psychological and social factors in various proportions. Psychoses are classified according to their origin (etiology) and reasons (pathogenetic mechanisms of development) into endogenous (including endogenous psychoses include schizophrenia, schizoaffective disorder, some psychotic forms of affective disorders), organic, somatogenic, psychogenic (reactive, situational), intoxication, withdrawal and post-withdrawal. Most often, psychoses develop in the framework of so-called endogenous disorder. The concepts of psychosis and schizophrenia are often equated, which is incorrect as psychotic disorders can occur in a number of mental illnesses: Alzheimer's disease and other types of dementia, chronic alcoholism, drug addiction, epilepsy, intellectual disabilities, etc. Other types of psychosis, such as infectious, somatic and intoxication psychoses are quite often find among patients in non-psychiatric practices. This review article is a good educational material for medical and psychological practitioners whose goal is to improve knowledge and diagnostic processes of psychosis and its related disorders.

Understanding psychosis: treatment and rehabilitation (updates for clinicians)

Psychosis is a group of psychotic disorders. Its manifestation depends on the specific type of functional violation. However, this is characterized by a gradual increase in clinical signs and a change in behavior. Symptoms of psychosis can be recognized by the following manifestations: hallucinations, delusional ideas, movement disorders, mood disorders including manic and depressive disorders and changes in emotional sphere. Psychosis occurs due to problems in the functioning of neurons. Due to the violation of bonds in the molecules, they do not receive nutrition and they are deficient in oxygen. This leads to the fact that neurons cannot transmit nerve impulses; multiple dysfunctions occur in the central nervous system. The type of psychosis depends on a part of the brain suffered from the hunger strike. The causes of this disorder are of 3 types: endogenous, associated with internal processes, exogenous or external and organic, when the causes of psychosis are changes in the brain such as tumors, trauma or hemorrhage. Psychosis is usually treated in a hospital setting. Such patients require urgent admission as they cannot control their actions, they can harm themselves and others. Psychosis is a relapse-prone disease. With timely and comprehensive treatment, the prognosis will be favorable. This review article is a good educational material for medical and psychological practitioners whose goal is to improve knowledge of treatment and rehabilitation processes of psychosis and its related disorders.

Mindfulness improves theory of mind in psychosis

Impaired Theory of Mind (ToM) ability is a core feature of psychotic disorders that challenges psychosis treatment. We aimed to explore the effect of a Mindfulness-Based Intervention (MBI) on ToM ability in a randomized clinical trial (RCT). A sample of 36 participants diagnosed with psychotic disorder were recruited from a community center and randomly allocated to Integrated Rehabilitation Treatment (IRT) or IRT+MBI. ToM skills were assessed through the Hinting Test and the Reading the Mind in the Eyes Test (RMET). IRT+MBI scored higher in RMET than IRT at posttreatment. MBI is a promising tool for improving ToM ability in psychosis.Keywords: psychotic disorders, theory of mind, mindfulness-based-interventions.

COVID-19 Induced Brief Psychotic Disorder: A Case Report and Review of Literature

The COVID-19 pandemic has significantly impacted people around the world, with asymptomatic infection to severe diseases and death. There is an increasing incidence of mental health problems in patients diagnosed with COVID-19. There are some studies that discuss possible mechanisms responsible for psychotic disorders due to coronavirus as well as risk factors for developing psychosis in patients infected with the virus. We report the case and a review of the literature in a 29-year-old female with no past psychiatric history who was diagnosed with a brief psychotic disorder following infection with COVID-19.

Easily Misdiagnosed cblC Deficiency in Adolescents: the Clinical and Metabolic Studies

Purpose: Adolescents are easily attacked by potential inherited metabolic disorders. cblC deficiency is the most common type of methylmalonic aciduria in China. The late-onset patients present with varied non-specific symptoms and usually being misdiagnosed. The purpose of this study is to investigate the clinical features of patients with adolescence-onset cblC deficiency and explore the prevention and control strategies. Methods: Fifty-seven patients (34 males and 23 females) with adolescence-onset cblC deficiency were admitted in our clinic from 2002 to September 2021. The diagnosis was confirmed by metabolic and genetic tests. The clinical and biochemical features, disease triggers, outcome and genotypes-phenotypes correlation were examined.Results: The onset ages ranged from 10 to 25 years old (median age was 12 years). 16 cases (28.0%) presented with symptoms after infection or sports training. 46 patients (80.7%) had neuropsychiatric diseases. 14 patients (24.6%) displayed cardiovascular diseases. Five cases (8.9%) showed pulmonary hypertension. Renal damage was observed in seven cases (12.3%). 23 mutations were identified from the MMACHC gene of 57 patients. 37 patients demonstrated c.482G>A (64.9%) and 16 cases had c.609G>A (26.3%). Among 13 patients that exhibited spastic paraplegia as a main manifestation, 10 patients had c.482G>A (76.9%). Five patients presented with psychotic disorders and spastic paraplegia with c.482G>A. All patients improved after metabolic treatment with cobalamin, L-carnitine, and betaine. 30 school-aged patients returned to school. Two patients were married and had healthy babies.Conclusion: Patients with adolescence-onset cblC deficiency presented with varied neuropsychiatric symptoms or multiple organ damage. Metabolic studies and individualized treatment are keys to improve the outcome of the patients.