TY - CHAP M1 - Book, Section TI - Pharmacotherapy of Psychosis and Mania A1 - Meyer, Jonathan M. A2 - Brunton, Laurence L. A2 - Chabner, Bruce A. A2 - Knollmann, Björn C. PY - 2015 T2 - Goodman & Gilman's: The Pharmacological Basis of Therapeutics, 12e AB - Psychosis is a symptom of mental illnesses characterized by a distorted or non-existent sense of reality. Psychotic disorders have different etiologies, each of which demands a unique treatment approach. Common psychotic disorders include mood disorders (major depression or mania) with psychotic features, substance-induced psychosis, dementia with psychotic features, delirium with psychotic features, brief psychotic disorder, delusional disorder, schizoaffective disorder, and schizophrenia. Schizophrenia has a worldwide prevalence of 1% and is considered the prototypic disorder for understanding the phenomenology of psychosis and the impact of antipsychotic treatment, but patients with schizophrenia exhibit features that extend beyond those seen in other psychotic illnesses. Hallucinations, delusions, disorganized speech, and disorganized or agitated behavior comprise the types of psychotic symptoms found individually, or rarely together, in all psychotic disorders, and are typically responsive to pharmacotherapy. In addition to positive symptoms, schizophrenia patients also suffer from negative symptoms (apathy, avolition, alogia), and cognitive deficits, particularly deficits in working memory, processing speed, social cognition, and problem solving that test 1.5-2 standard deviations below population norms (Green et al., 2004). Cognitive dysfunction is the strongest predictor of functional impairment among schizophrenia patients, yet negative symptoms and cognitive deficits show limited improvement with antipsychotic treatment (Buchanan et al., 2007). That schizophrenia is not identical to other psychoses is important for appreciating the differential impact of antipsychotic medications on psychotic symptomatology, and for understanding the rationale for non-dopaminergic antipsychotic drugs based on the underlying pathophysiology of schizophrenia (Carpenter and Koenig 2008). SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2023/09/28 UR - accessmedicine.mhmedical.com/content.aspx?aid=1127866130 ER -