PSYCHOTIC DISORDERS: A SYSTEMATIC REVIEW

Abstract

Psychotic disorders are a heterogeneous group of severe mental conditions that affect perception, thought, affect, and behavior. They are characterized by the presence of psychotic symptoms, such as delusions, hallucinations, disorganized thinking, and abnormal motor behavior. Schizophrenia is the best-known and most studied psychotic disorder, but other disorders, such as schizoaffective disorder, delusional disorder, brief psychotic disorder, and substance-induced psychotic disorder, are also part of this spectrum. The etiology of psychotic disorders is complex and multifactorial, involving genetic, neurobiological, environmental, and psychosocial factors. Neuroimaging and neurochemical studies have demonstrated structural and functional alterations in the brains of patients with psychosis, mainly in the frontal, temporal, and limbic regions. Dysregulation in neurotransmitter systems, such as dopamine, glutamate, and serotonin, has also been implicated in the pathophysiology of these disorders. The diagnosis of psychotic disorders is based on the clinical evaluation of symptoms and the course of the illness, following the criteria established in diagnostic manuals, such as the DSM-5 and ICD-11. A comprehensive assessment is fundamental, including the patient's personal and family history, mental status examination, exclusion of other medical or psychiatric conditions that may be causing the psychotic symptoms, and evaluation of the functional impact of the illness. Treatment of psychotic disorders generally involves a combination of pharmacological, psychosocial, and rehabilitation interventions. Antipsychotics are the first-line medications for the treatment of psychotic symptoms, acting primarily by blocking dopamine receptors in the brain. Psychosocial therapies, such as cognitive-behavioral therapy, family therapy, and social skills programs, aim to improve patients' social and occupational functioning, reduce stigma, and promote treatment adherence. Psychosocial rehabilitation is a set of strategies aimed at helping patients recover skills and roles lost due to illness, such as work, study, and leisure.