Magazine article Clinical Psychiatry News

Postpsychotic Adjustment May Be Part of Psychosis: PPAS Is a Changing State. (Postpsychotic Adjustment State)

Magazine article Clinical Psychiatry News

Postpsychotic Adjustment May Be Part of Psychosis: PPAS Is a Changing State. (Postpsychotic Adjustment State)

Article excerpt

NEW YORK -- A psychotic episode is a traumatic event, and what appears to be a subsequent psychotic episode might actually be a normal part of the emergence from that event, Mary D. Moller said at a meeting of the World Association for Psychosocial Rehabilitation.

In some cases, the patient may be suffering from what has recently been termed postpsychotic adjustment state (PPAS), which describes the "sadly neglected aftermath of psychosis," said Ms. Moller, an advanced-practice registered nurse who is clinical director of the Suncrest Wellness Center, an outpatient psychiatric clinic in Nine Mile Falls, Wash.

PPAS is more of a phenomenon than a diagnosis, as it is a changing state, said Ms. Moller, who in collaboration with Dr. Carol S. North, professor of psychiatry at Washington University School of Medicine in St. Louis, first formally described and studied the condition. It is a state often misdiagnosed as a relapse or an exacerbation of schizophrenic symptoms, she said.

PPAS is characterized by intense interpersonal feelings such as fear, failure, humiliation, shame, anxiety, and anger associated with the psychotic episode. The fear--particularly of symptom return, medical treatments, and inability to regain or maintain control--can be the most debilitating aspect of the state.

Onset of PPAS is variable, but there are some common patterns. In the first few months, PPAS patients who remain in treatment may slowly lose interest in trying to recover. They may undergo a number of medication changes only to find that treatment isn't working, and they may appear clinically depressed.

Toward the end of the first year, they may become overwhelmed by trying to manage symptoms, and may become unable to carry out normal activities of daily living. Treatment at this phase fails to engage the patient in any discussion of their emotional state, Ms. …

Search by... Author
Show... All Results Primary Sources Peer-reviewed

Oops!

An unknown error has occurred. Please click the button below to reload the page. If the problem persists, please try again in a little while.