Krstev, Helen (2011) Reactive psychosis in a first-episode psychosis population. Other Degree thesis, Victoria University.

Abstract

Contemporary western psychiatry is disengaging too readily with the notion that severe mental disorder characterised by psychotic experiences such as hallucinations and delusions can be a primary reaction to overwhelming stress or distress (Ungvari & Mullen, 2000). Reactive psychosis, a term coined over a century ago to differentiate these disorders from other psychotic processes more closely resembling schizophrenia, was investigated in 217 first episode psychosis patients being treated at the Early Psychosis Prevention and Intervention Centre, in Melbourne, Australia. Reactive psychosis criteria were first operationalised using the Reactive Psychosis Rating Form (RPRF). These patients’ course and outcome were then compared with their non-reactive psychosis counterparts over a 15-month follow up period. Twenty nine percent of first-episode psychosis patients met criteria for reactive psychosis. The reactive psychosis group had a more rapid initial recovery from their psychosis and social and occupational impairments, compared with their non-reactive psychosis counterparts. Clinical practice at the centre dictated that these patients had discontinued their anti-psychotic medication faster than the non-reactive psychosis group, suggesting the need to reconsider early psychosis treatment guidelines.

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