a young persons guide to PSYCHOSIS

Ok, this all sounds a bit freaky - psychosis? Well, it's not as scary and is a good bit more common than you might think. Read on to discover the cutting edge research on the mental health of young people that Irish scientists in the Royal College of Surgeons and Trinity College Institute of Neuroscience are carrying out right now.

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Psychosis is ​a condition where the person loses touch with reality. They may hear sounds that are not there, see or feel things that are not there. 

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Traditionally everyone thought that people who talked about these symptoms needed to be hospitalized and in treatment by a psychiatrist.

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What we're realizing more and more now is that we need to do is to separate psychotic disorders like schizophrenia from psychotic symptoms like hearing voices. It's perfectly possible to have a psychotic symptom without a psychotic disorder. Indeed, 1 in 20 adults and up to 1 in 5 young people experience psychotic symptoms without experiencing a psychotic disorder.

Historically hearing voices was interpreted as someone who was psychic or who had special powers and some people were revered in the community for this.

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We've done a lot of work breaking down stigma on a lot of mental health issues but psychosis remains the last frontier. It's only by getting the message across that these symptoms are much more common than once thought, that we can realize that psychosis isn't something that belongs in an institution -  it's just part of the human condition.

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There are both positive and negative symptoms.

Positive symptoms are where we create something:

  • Hallucinations - perceptions without an object in reality

  • Delusions - belief without a basis in reality

 

The most common symptom we find in our research is hearing voices (auditory hallucinations).

Negative symptoms are where we can't carry out everyday tasks, these include:

  • lack of energy

  • lack of interest

  • not wanting to speak or do things

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How many people actually hear voices?​

The first thing we need to do is to separate psychotic disorders like schizophrenia from psychotic symptoms like hearing voices. It's perfectly possible to have a psychotic symptom without a psychotic disorder. 

Psychotic symptoms are much more common that we had once thought, particularly in young people. We have found rates of up to 10% in young people and up to 20% in 11-12 year olds.

Interview with Professor Mary Cannon

Professor Mary Cannon is one of the leading researchers in Ireland looking at psychosis in young people. We talk to her about how we go about studying something like psychosis.

How do you find out if people are experiencing psychosis?

Basically we ask them. There isn't currently a blood test or brain scan to detect psychosis so my team designs questionnaires that we can give out to groups of young people. We also carry out one-to-one interviews to talk about young people's experiences. 

What is the most common psychotic symptom?

Hearing voices, this is by far the most common. One of the next questions is what kind of voice is it? There's a big difference between one that's curious or observant and one that's paranoid or cruel.

What challenges do you face in your research?

One problem is whether people are honest in their answers. Some people are afraid to say that they experience a psychotic symptom like hearing voices in case people might think they're crazy. Fortunately we're learning a lot more about psychosis than we knew years ago and it's actually quite common to have a psychotic experience without having any mental health problems.

How do you carry out your research?

We do what's called a LONGITUDINAL or COHORT study.  Basically, we take a group of young people and follow them up over the course of their adolescence and into young adulthood. We want to study how young people change over time in terms of their mental health and also in terms of their brain development because we know the brain changes a lot through the teenage years.

 

We are particularly interested in young people who reported symptoms like depression or anxiety or hearing voices and we want to investigate whether these symptoms disappear over time and how these symptoms might affect how the young people get on in their adult lives. In order to study this we can carry out what is called a CASE-CONTROL study where we directly compare young people who have symptoms with those who don’t have such symptoms.

We are also asking the young people to have brain scans and to do some tests of brain function like attention and memory because we wish to investigate if having symptoms like hearing voices  or depression or anxiety have an effect on brain function or structure and whether this might change over time. So far we are not finding any major effects on the brain so that is good news. We are very grateful to all the young people who have taken part in our study.

Any surprises in your research findings?

Yes, far more young people reported a psychotic symptom like hearing voices than we expected. 22% of young people aged 11-13 reported having had a psychotic symptom. We are finding that for most young people these symptoms disappear as they get older. For some young people it is a sign of stress in their lives and if this stress goes away then so does the symptom!

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Finding out that psychosis is much more common that we once thought has led to a paradigm shift in our thinking. Hearing voices and other psychotic symptoms are no longer something signs of madness, but may indeed be part of the human condition.

This helps us take away some of the stigma surrounding these mental health issues and can allow us to start a conversation. 

A small number of people who experience psychosis do go on to develop more serious mental illnesses. A big focus of our research is about trying to identify those people as early as possible so that we can give them the help they need.

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Unsure about how this ties into the Junior Cycle Science Specification? Read our teacher's notes to see how this topic can be used with Junior Cycle students.

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A short guide aimed at young people.

A UK group for people who hear voices, their relatives, friends and carers and interested mental health professional’s.

A less medical approach to psychosis.

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Journey Through the Brain

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Download a PDF copy of the book

In 2016 a group of RCSI scientists (including members of the ABD team) published ‘Journey Through the Brain’, a colouring book intended to bring to life the work they do and present it to a younger audience.

 

This year, the project won an RCSI Research Day Innovation Award.

The project was funded by the Health Research Board Knowledge Exchange and Dissemination Scheme, and illustrated by Dr Eoin Kelleher of the RCSI. The drawings introduce the user to the parts and activities of the brain, and its relationship with mental health and wellbeing, while accompanying text provides associated names and information. The authors hope the book will introduce young people to neuroscience, but given that colouring is becoming an increasingly popular way of counteracting anxiety and stress among adults it may well be of interest to all ages!

Royal College of Surgeons Factsheets

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1 - Understanding Psychosis

What is psychosis, what are the symptoms and what causes it?

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2 - Recognising Signs of  Psychosis

How to recognise the signs of psychosis and what to do if you notice them?

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3- Talking to Someone about Psychosis

What to do if you think someone you know has psychosis.

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4- Getting Help for Psychosis

Where to go, service you can use, and different treatments for psychosis.

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5- Looking After Yourself when Someone You Know has Psychosis

Where to get information, find support, and useful websites and organisations.

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6-  Psychotic Experiences in Adolescence

The difference between psychotic experiences and disorders, how common are psychotic experiences in adolescence and are there risks associated with them?