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11 - Psychotic disorders

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Summary

Psychotic disorders are unusual in childhood and adolescence but are serious when they occur. They consist of:

  1. • bipolar disorder (severe mood swings); this used to be called manic–depressive psychosis

  2. • delusions (false ideas without any basis in reality), hallucinations (sensory perceptions such as hearing voices when there is no one there) and disorders of thinking. These are most likely to be signs of schizophrenia, which may take different forms. All are serious, but there are now effective treatments for schizophrenia.

Bipolar disorder

Case

Indira was a 14-year-old girl brought to see a health professional by her mother. Her mother said that she had had to drag Indira to the clinic because she had not wanted to come and thought there was nothing wrong with her. Indira thought that she had never felt better. But for the past 3 months she had become more and more difficult and impulsive. She talked much more than normal and it was hard to interrupt her once she started. She got very angry when she was interrupted. She had been stealing money from her mother's purse and spending it on clothes she could not possibly afford. She was sleeping much less, only about 5 hours a night. Indira had never behaved like this before. She had always been a rather shy girl. About 2 years ago she had gone through a period of 6 months when she was sad and miserable and did not want to go out. It had never been clear why she was so depressed at this point. Indira's father had left home some years ago, after having relationships with a number of other women. He did not keep in touch. Indira has no brothers or sisters. What should the health professional do?

Information about bipolar disorder

People with bipolar disorder do not understand that they have a mental illness – they lack insight. It is called bipolar disorder because many people experience unusually elevated and depressed states for periods of time. Some people only have episodes of unusual happiness or irritability. The illness does not usually start before mid-adolescence.

Type
Chapter
Information
Where There is No Child Psychiatrist
A Mental Healthcare Manual
, pp. 107 - 111
Publisher: Royal College of Psychiatrists
First published in: 2017

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