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Published on: May 15, 2020
Secondary psychoses: an update.
Matcheri S Keshavan1, Yoshio Kaneko
1Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA.
Summary
Secondary psychoses, caused by medical conditions or substance use, are distinct from primary psychotic disorders. Studying these secondary cases offers insights into the causes of conditions like schizophrenia.
Area of Science:
- Psychiatry
- Neurology
- Neuroscience
Background:
- Historically, psychoses were misclassified as organic or functional.
- The concept of secondary psychoses emerged to categorize disorders with known medical or substance-related causes.
- This distinction is crucial for accurate diagnosis and understanding psychosis.
Purpose of the Study:
- To review the historical evolution of psychosis classification.
- To outline the diagnostic approach and clinical features of secondary psychoses.
- To explore how studying secondary psychoses can illuminate the pathophysiology of primary psychoses like schizophrenia.
Main Methods:
- Historical literature review on psychosis classification.
- Clinical feature analysis for diagnosing secondary psychotic disorders.
- Case study analysis of specific secondary psychoses (temporal lobe epilepsy, velocardiofacial syndrome, NMDA receptor encephalitis).
Main Results:
- The classification of psychosis evolved from organic/functional to primary/secondary.
- Key diagnostic indicators for secondary psychosis include atypical presentation and a clear etiological link.
- Specific secondary psychoses serve as models for primary psychosis research.
Conclusions:
- Secondary psychoses are disorders with identifiable medical or substance-related causes.
- Understanding secondary psychoses aids in differentiating them from primary psychotic disorders.
- These conditions offer valuable models for investigating the neurobiology of schizophrenia.
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