ABSTRACT
This chapter presents some interesting concepts about the psychoses and useful consultation questions. 'Psychosis' refers to a real 'mixed bag' of problems. 'Positive' symptoms are hallucinations and delusions. The newer 'atypical' antipsychotic medications target the negative symptoms better by acting on a number of receptors, bringing about change in a number of neurotransmitter systems. Patients can develop secondary negative symptoms – a side-effect of antipsychotic medication and most likely in first generation antipsychotics. However, there is growing support for a neuro-developmental model with behavioural, cognitive and motor differences being found in children who develop psychoses. Having a register of patients with significant mental health problems and carrying out regular health reviews will help to prevent future ill health. With the exception of clozapine which seems superior in treatment resistant cases, there is no convincing evidence that the newer drugs are more effective at treating psychosis.
