Psychotic disorders

What are psychotic disorders?

Psychotic disorders are a set of disorders characterised by symptoms which affect normal thinking and perception. These can include hearing voices, holding beliefs that would seem odd to most people and paranoid ideas. People may also experience the feeling that thoughts are being removed or inserted into their mind, as well as experiencing a loss of pleasure, difficulties in communicating their thoughts or a lack insight and self-awareness. Schizophrenia is a diagnosis for a set of these symptoms which meet certain criteria in terms of severity and duration according to diagnostic classification systems. People with bipolar disorder or severe depression may also exhibit some of these psychotic symptoms. Psychotic disorders can be very scary for people experiencing them and their families and friends. However, with early treatment and support many people with schizophrenia and other psychotic disorders can recover and lead active, productive lives.

An overview of key facts about schizophrenia, via Rethink

Who is at risk?

Anyone can experience a psychotic disorder. On average about 1% of the population will experience a psychotic disorder over the course of their life time. The symptoms of psychotic disorder can begin in early adolescence and occur at any time in adult life, though people in their late teens and twenties are most at-risk . On average schizophrenia is twice as common in men than women, though the risk of affective psychotic disorders is similar for both sexes . A family history of psychotic illness also increases risk.

Many people experience psychotic symptoms in their life time, but for most people they will disappear very quickly. Only psychotic symptoms which persist usually require medical help. However, if you are worried about any unusual symptoms your GP can provide help and support. Plenty of other help & support is also available.

What are the causes?

Currently we don’t know what the precise causes of psychotic disorders are. We do know that both genetic and environmental factors are likely to play a part . Scientists have found many genetic variants which increase risk, but on average by a very small amount. Stressful life events, including childhood trauma, migration  or being a member of a minority ethnic group  have also been shown to increase risk. Certain environmental factors, such as the use of cannabis or other drugs, as well as being born, brought-up or living in more urban, deprived or unequal neighbourhoods may also increase risk . Although these factors increase risk, it is important to remember that because psychotic disorders are rare the vast majority of people exposed to such risks will never experience psychotic disorder . Our research investigates the role of migration, ethnic minority status and urban living on psychosis risk, and how this may combine with genetic factors to alter risk.

What are the consequences?

With appropriate medication, hallucinations and delusions can often be effectively controlled. Unfortunately these treatments work less well on other symptoms (such as problems with thinking, speech and other cognitive difficulties), and people with psychotic disorder may often find it difficult to maintain the same level of social and economic functioning they had prior to the onset of illness. Some treatments have undesirable side effects making it difficult to keep taking medication (especially when the delusions and hallucinations appear to have gone), which may lead to the re-occurrence of an episode of psychosis. Unfortunately people with schizophrenia live, on average, 10-20 years shorter than the rest of the population. Although the increased level of suicide partly contributes to this difference in life expectancy, it is also due to poorer lifestyle choices (including less exercise, worse nutrition & more smoking) and poorer receipt of physical health care in the NHS. We support the need for equivalence of physical and mental health to be recognised by the NHS .

Can people recover?

Psychotic disorders can be highly debilitating, and people with psychotic disorders often experience a lot of stigma in society. However, people with psychotic disorder can also recover from their illness. While definitions of recovery vary, many people with psychosis are able to manage their symptoms sufficiently to lead active, social lives, often returning to employment. The clinical, social and economic outlook for people with psychotic disorder appears to be best when they receive mental health care as close as possible to the onset of their symptoms. This means it is important to seek advice quickly if you are worried about your mental health.

Want the science behind the blurb? Follow the links below to the peer-reviewed research papers.

Kirkbride JB, Jones PB. Parity of esteem begins at home: translating empirical psychiatric research into effective public mental health. Psychological Medicine [Internet]. 2014 [cited 2013 Jan 1];44(8):1569–76. Available from:
Coid JW, ``1, Q 1Q`, Q1 F, 1 R, Yang M, et al. Raised incidence rates of all psychoses among migrant groups: findings from the East London first episode psychosis study. Arch Gen Psych [Internet]. 2008;65(11):1250–8. Available from:
Tortelli A, Errazuriz A, Croudace T, Morgan C, Murray RM, Jones PB, et al. Schizophrenia and other psychotic disorders in Caribbean-born migrants and their descendants in England: systematic review and meta-analysis of incidence rates, 1950-2013. Soc Psychiatry Psychiatr Epidemiol. 2015 Feb 7;
Kirkbride JB, Jones PB, Ullrich S, Coid JW. Social Deprivation, Inequality, and the Neighborhood-Level Incidence of Psychotic Syndromes in East London. Schizophrenia Bulletin [Internet]. 2014 Jan 1;40(1):169–80. Available from:
Kirkbride JB, Fearon P, Morgan C, Dazzan P, Morgan K, Tarrant J, et al. Heterogeneity in Incidence Rates of Schizophrenia and Other Psychotic Syndromes: Findings From the 3-Center ÆSOP Study. Arch Gen Psychiatry [Internet]. 2006 Mar 1;63(3):250–8. Available from:
Fearon P, Kirkbride JB, Morgan C, Dazzan P, Morgan K, Lloyd T, et al. Incidence of schizophrenia and other psychoses in ethnic minority groups: results from the MRC AESOP Study. Psychological Medicine [Internet]. 2006;36(11):1541–50. Available from:
Kirkbride J, Boydell J, Ploubidis G, Morgan C, Dazzan P, McKenzie K, et al. Testing the association between the incidence of schizophrenia and social capital in an urban area. Psychological Medicine [Internet]. 2008;38(8):1083–94. Available from:
Kirkbride JB, Barker D, Cowden F, Stamps R, Yang M, Jones PB, et al. Psychoses, ethnicity and socio-economic status. British Journal of Psychiatry [Internet]. 2008;193(1):18–24. Available from:
Kirkbride JB, Jones PB. The Prevention of Schizophrenia—What Can We Learn From Eco-Epidemiology? Schizophrenia Bulletin [Internet]. 2011;37(2):262–71. Available from:
Kirkbride JB, Errazuriz A, Croudace TJ, Morgan C, Jackson D, Boydell J, et al. Incidence of Schizophrenia and Other Psychoses in England, 1950–2009: A Systematic Review and Meta-Analyses. PLoS One [Internet]. 2012;7(3):e31660. Available from:
Kirkbride JB, Morgan C, Fearon P, Dazzan P, Murray RM, Jones PB. Neighbourhood-level effects on psychoses: re-examining the role of context. Psychol Med [Internet]. 2007;37(10):1413–25. Available from:
Kirkbride JB, Fearon P, Morgan C, Dazzan P, Morgan K, Murray RM, et al. Neighbourhood variation in the incidence of psychotic disorders in Southeast London. Social Psychiatry and Psychiatric Epidemiology [Internet]. 2007;42(6):438–45. Available from:

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