Post on 13-Apr-2017
PSYCHOSIS: SYMPTOMS, WARNING SIGNSAND STEPS TO EFFECTIVE TREATMENT
THE BASICSPsychological and emotional difficulties are like other medical problems; early signs and symptoms usually occur before serious illnesses develop. As with other medical illnesses, the sooner psychological problems are identified and treated, the less likely they are to disrupt a person’s ability to study, work, make friends and be with others. Early identification and treatment can lead to a better prognosis.
OUR MISSION:To work with our community to transform pathways to care for those who have recently suffered the onset of a psychotic illness or are showing the warning signs that they may be at risk of developing a serious mental illness like psychosis
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The Genetics of Mental DisordersPsychotic disorders are complex and appear to
involve multiple susceptibility genes interacting with multiple environmental factors throughout the development of the person. The nature of these interactions is very complex and poorly understood at this time.
In order to avoid the deterministic viewpoint of mental illness, it is crucial to emphasize the importance of the environment and lifestyle choices and that there is hope for recovery.
Taking illicit drugs is a preventable risk factor, as is excess stress.
PSYCHOSIS IS MORE COMMON THAN YOU THINK• More common than Multiple Sclerosis and Muscular Dystrophy
combined• Psychosis effects about 3% of the world’s population
FOR EVERY ONE PERSON AFFECTED BY PSYCHOSIS, THERE ARE 6 MORE FAMILY AND FRIENDS AFFECTED
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IT’S A YOUNG PERSON’S DISEASE• Most mental illnesses are chronic diseases of the young• Symptoms commonly first appear in people age 12-25
3585% OF PEOPLE SUFFERING FROM PSYCHOTIC ILLNESSES DEVELOPED THIS BEFORE THEY TURNED 35
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SO WHAT IS PSYCHOSIS?Psychosis is a mental health problem that causes people to perceive or interpret things differently from those around them. This might involve hallucinations or delusions. It is any severe mental disorder in which contact with reality is lost or distorted.
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Psychosis
Positive Symptoms Negative Symptoms
Hallucinations Lack of interestDelusions Lack of motivationThought Disorder Lack of pleasureBizarre Behavior Social withdrawal
Blunted affectLethargyApathy
Phases of Psychosis
PREMORBID AT RISK ACTIVE
Func
tion
ing
Course of Illness
*First appropriate treatment
Onset of illness
Duration of Untreated Psychosis
Decrease in functioning, Beginning
of mild but not yet psychotic symptoms.
Summary of Relevant Research1) Early Identification and early intervention
appear to lead to better prognosis.Australian EPPIC Program
2) It is possible to reduce theduration of untreated Psychosis.Norwegian TIPS Project
3) It appears to help to identify people “at risk” for serious mental illness.British Early Intervention Study
4) It is possible to identify people in a pre-psychotic state.PACE, TOPS, and PRIME Data
TIPS LATE-BREAKING FINDINGS
Baseline ED vs UD Differences
- Less suicidality with ED
- Less involuntary hospitalization with ED
- Holds true even 10 years out
Case for Early Intervention
• At onset, already present are:• Measurable cognitive impairment• Measurable gray matter volume loss• Damaging social development losses• Diminished capacity to actively engage in treatment
SO WHAT ARE THE COMMON CAUSES OF PSYCHOSIS?
• mental illnesses (e.g. schizophrenia)• medical illnesses (e.g. epilepsy)• substances: such as alcohol or drugs
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JUST LIKE ANY OTHER MEDICAL PROBLEM• People suffering from psychosis did nothing to
“cause” their disease• It requires treatment just like any other illness or
injury• The sooner someone gets treatment the more
likely they are to get better
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THE KEY TO SEEKING HELP IS UNDERSTANDING SYMPTOMS AND SIGNS
• Hallucinations - seeing or hearing things that aren’t there• Delusions - believing things that aren’t true, and are often impossible• Thought Disorder - trouble putting thoughts in order or keeping track of usual tasks• Lack of insight and self-awareness
The combination of hallucinations and delusional thinking can often severely disrupt perception, thinking, emotion and behavior.
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SIGNS OF PSYCHOSISWatch for changes in behavior such as:• withdrawing from usual activities with friends• spacing out or falling behind in tasks• social isolation
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SIGNS IN SCHOOL
• Falling asleep in class• Struggling with basic work• Paying less attention to personal appearance and hygiene
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Behaviors of ConcernWithdrawal/Isolation
Ongoing Social Difficulties
Poor Hygiene
Bizarre Behavior/Appearance
Falling Asleep in Class Repeatedly
Sadness/Tearfulness
Excessive Anxiety
Absenteeism/Staying in Room
Poor Concentration/ Spacing Out
Hypervigilance
Decrease in Work Performance/Activity Level
Becoming Neglectful and Unfeeling
Emotional Outbursts/Emotional Flatness
Behaviors of ConcernIdentify recent changes
Identify more than one behavior of concern
Identify distress level associated with behavior of concern
Identify interference with functioning associated with behavior of concern
Early Warning Signs of Psychosis:
Increased difficulty at school or workWithdrawal from friends or family
Difficulty concentrating or thinking clearly
Suspiciousness or mistrust of others
Changes in the way things look or sound
Odd thinking or behavior
Emotional outbursts or lack of emotion
Poor personal hygiene
Is someone you know at risk?
Some Typical Queries and Responses
Have you felt that you are not in control of your own ideas or thoughts?
Do you ever feel that your mind is playing tricks on you? Déjà vu, minding reading?
Your ears? More sensitive to sounds? Ringing in your ears? Name being called? Cell phone ringing?
Your eyes? More sensitive to light? Flashes, flames, vague figures or shadows out of the corner of your eyes?
Do you seem to be having trouble getting your point across? Following multi-step directions?
Changes in the Way Things Look or Sound
• Wind rushing by ears
• Noisy pipes
• Hall to the Cafeteria
Odd Thinking• School class watching him
• Traffic lights have meaning
• Friends might be only pretending
• Teachers might be against
“IT STARTED WITH MYLOSS OF INTEREST INBASICALLY EVERYTHING”
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WHAT TO DO IF YOU SEE THE SIGNSIf you believe you see the signs of psychotic disorder in someone you know then they need your help.
IF YOUR FRIENDWAS HURTINGYOU’D CALLA DOCTOR
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CALL FOR HELPSTEP CLINIC203-589-0388www.mindmapct.org
PRIME CLINIC1-866-AT-PRIME OR 203-785-2100http://primeclinic.yale.edu
Treatment is effective. The sooner treatment is started, the better the recovery.
MYTH:TREATMENT DOESN’T WORK
#1
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Early treatment often happens in an office. The patient comes in for treatment and then goes home again.
MYTH:TREATMENT MEANS BEING LOCKED IN A HOSPITAL
#2
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OUR TREATMENT:
• a full assessment of your needs to navigate a clear path to mental health
• rapid referral to appropriate service in local community or engagement in STEP or PRIME
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OUR TREATMENT:
• prescriptions for medications when required
• psychotherapy• education and support for patients and
families• support for employment and
educational goals
INTRO PREVALENCESYMPTOMSSIGNS MYTHS TREATMENT
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High School
College
Mental HealthServices
PublicCharity/Clergy
Primary CareHospital
SocialServices
JudicialPolice/Probation
Consumer/Youth/Orgs.
Branches ofGovernment
PATHWAYS TO CARE: MINDMAP
STEP CLINIC
• PERSONS AGED 16 – 35 WITH PSYCHOSIS EARLY IN THE COURSE OF TREATMENT
• DIAGNOSTIC CLARIFICATION EVALUATION
• MEDICATION MANAGEMENT, INDIVIDUAL, GROUP, FAMILY THERAPY, & VOCATIONAL ENGAGEMENT
• FLEXIBLE, INDIVIDUALIZED, RECOVERY ORIENTED TREATMENT WITH EMPHASIS ON ENGAGEMENT
Free Effective Local
HELP IS AVAILABLE
203 589 0388www.mindmapct.org
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PRIME CLINIC 203-785-2100
• PERSONS BETWEEN 12 - 35 YEARS OF AGE• CAN RESIDE ANYWHERE AS LONG AS CAN COME INTO
THE CLINIC IN NEW HAVEN• MUST HAVE MINIMUM IQ OF 70• MUST HAVE NEVER MET CRITERIA FOR FULL BLOWN
PSYCHOSIS• PROVIDES CLINICAL EVALUATION, DIAGNOSTIC
CLARIFICATION, COMMUNITY EDUCATION, CONSULTATION WITH COMMUNITY PROVIDERS & SCHOOL PERSONNEL, & TREATMENT STUDIES
* ALL SERVICES ARE FREE OF CHARGE
Dr. Barbara Walsh203-974-7052
Call (TOLL FREE) 1-866-at PRIME or 203-785-2100
OUR COMMUNITY ONLINE:
OWNED MEDIAEARNED MEDIA
PAID MEDIA
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WHAT CAN YOU DO? SPREAD THE WORD