Psychosis and schizophrenia Lyra Health Seminar
Contents Overview This seminar explores psychotic experiences and schizophrenia. It combines real-world narratives, clinical tools, and scientific models to promote understanding and effective care strategies. Participants will learn to identify red flags, communicate compassionately, and support recovery in individuals experiencing psychosis.
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Psychosis: Definition & Types Psychotic experiences : Disruptions in perception, cognition, and reality monitoring. Core phenomena : Hallucinations Delusions Disorganized speech or behavior Thought insertion and passivity experiences Associated disorders : Schizophrenia spectrum, mood disorders with psychotic features, substance-induced psychosis Diagnosis & Classification DSM-5 Criteria for Schizophrenia : Two or more core symptoms for at least one month Functional impairment and chronicity (6+ months total) ICD-10 vs ICD-11 : ICD-11 eliminates subtypes New symptom specifiers and clearer course patterns Syndrome vs. diagnosis : Psychosis is a transdiagnostic state, not a single disease Course & Epidemiology Onset: Adolescence to early adulthood (earlier in males) Prevalence: ~0.5% globally Course: Prodrome → first episode → variable outcomes Recovery, relapse, or chronic course Better prognosis with early detection, support, and treatment Causes & Risk Factors Biopsychosocial framework : Genetic : Family history increases risk Environmental : Trauma, urbanicity, substance use (esp. cannabis) Neurodevelopmental : Obstetric complications Models : Diathesis-stress Predictive coding failures Neurodevelopmental cascade Cognitive misattribution theories Detection & Assessment Red flags : Social withdrawal, odd beliefs, suspiciousness, functional decline Tools : Structured interviews (e.g. PANSS, CAPS, PDI, BPRS) Clinical assessment : Emphasis on insight, affect, and reality testing Early digital screening tools show promise Communication Strategies Principles : Validate emotions, not delusions Maintain calm, non-confrontational stance Respect autonomy and foster collaboration Digital care : Extra focus on tone, predictability, grounding Document risk carefully Evidence-Based Treatments Multimodal care : Antipsychotic medication CBT for psychosis (CBTp) Family interventions Supported employment and housing Recovery framework : Hope, empowerment, shared decision-making Seamless transitions and outpatient integration Peer support and case management Case Studies The Suspicious Neighbor : Early paranoia, responsive to early intervention Voices on the Line : Acute psychosis during crisis, role of decompensation The Impostor Family : Delusional misidentification linked to trauma The Silent Withdrawal : Gradual disengagement, missed early signs Summary & Reflections Psychosis reflects breakdowns in perception and cognition Effective detection and care require curiosity, compassion, and coordination Integrating biological and lived perspectives is key to reducing stigma and supporting healing Resources