Psychosis is a loss of contact with reality that manifests in abnormal perception, thinking and behaviour. These abnormalities can include hallucinations (e.g. hearing non-existent derogatory voices), delusions (e.g. of government surveillance and persecution), disorganised movement, poor motivation, slowed thinking, and loss of expression of emotions.
In severe psychosis, a person’s speech and therefore thinking may become so disorganised that topics change from moment to moment without relationship. Behaviour can also be disorganised, from low levels of self-initiated activity to furious and bizarre movement without a specific goal.
Psychotic illness may be episodic or chronic, and can occur in both severe mood disorders such as bipolar disorder or primary psychotic disorders such as schizophrenia. Up to one-quarter of patients receive little or no benefit from regular antipsychotic medication, but many patients are able to live relatively symptom-free if treated appropriately.
The 12-month prevalence of psychotic illness managed within Australian public mental health services has recently been estimated at 4.5 per 1000 people. Up to half of these patients have reported a suicide attempt in their lifetime; more than 60% report only partial recovery or continuous chronic illness; 32% have a severe dysfunction in the quality of self-care; and 85%...