A short seminar overview of psychosis, schizophrenia, and evidence-based care.
Overview
This seminar gives a short introduction to psychotic experiences and schizophrenia through clinical examples, diagnostic frameworks, and scientific models. The aim is practical: improve recognition, communication, and evidence-based support for people experiencing psychosis.
Psychosis: Definition & Types
Psychotic experiences involve disruptions in perception, thought, and reality monitoring.
Core phenomena include hallucinations, delusions, disorganized speech or behavior, and passivity experiences.
Associated disorders include schizophrenia spectrum disorders, mood disorders with psychotic features, and substance-induced psychosis.
Diagnosis & Classification
DSM-5 schizophrenia criteria require characteristic symptoms, functional impairment, and persistence over time.
ICD-11 moves away from older subtypes and emphasizes symptom specifiers and course patterns.
Psychosis as syndrome: psychosis is best understood as a transdiagnostic state rather than a single disease.
Course & Epidemiology
Onset is typically in adolescence or early adulthood, often earlier in males.
Prevalence is about 0.5% worldwide.
Course often spans prodrome, first episode, and then highly variable outcomes, including recovery, relapse, or chronicity.
Prognosis improves with early detection, support, and treatment.
Causes & Risk Factors
Biopsychosocial models integrate genetic, environmental, and neurodevelopmental risk factors.
Genetic risk is elevated by family history.
Environmental risk includes trauma, urbanicity, and substance use, especially cannabis.
Conceptual models include diathesis-stress, predictive coding accounts, neurodevelopmental cascades, and cognitive misattribution frameworks.
Detection & Assessment
Red flags include social withdrawal, odd beliefs, suspiciousness, and functional decline.
Assessment tools include structured interviews such as PANSS, CAPS, PDI, and BPRS.
Clinical assessment focuses on insight, affect, and reality testing; early digital screening tools may complement this work.
Communication Strategies
Clinical principles: validate emotions without affirming delusional content, stay calm, and support collaboration.
Digital care requires extra attention to tone, predictability, grounding, and careful risk documentation.
Evidence-Based Treatments
Multimodal care includes antipsychotic medication, CBT for psychosis (CBTp), family interventions, and practical support around work and housing.
Recovery-oriented care emphasizes hope, empowerment, shared decision-making, continuity of care, peer support, and case management.
Case Studies
The Suspicious Neighbor: early paranoia that responded well to early intervention.
Voices on the Line: acute psychosis during crisis and the role of decompensation.
The Impostor Family: delusional misidentification in the context of trauma.
The Silent Withdrawal: gradual disengagement and missed early warning signs.
Summary & Reflections
Psychosis reflects breakdowns in perception, inference, and cognition.
Effective detection and care require curiosity, compassion, and coordination.
Integrating biological and lived perspectives is essential for reducing stigma and supporting recovery.