Q&A: UofC’s Dr. Vina Goghari Demystifies Psychosis In Youth

Being labelled as psychotic is one of the greatest fears among youth experiencing mental illness.

The term refers to a loss of contact with reality; when people can’t tell the difference between what is real and what is not. Unfortunately, it is one that’s widely misunderstood and often misinterpreted to identify a person as dangerous or violent. And it’s assumptions like this that stigmatize and build obstacles to a person’s path to recovery.

The truth is, psychotic disorders – otherwise known as psychosis – are mental disorders that include hallucinations or delusions, among other symptoms. They typically emerge during adolescence and young adulthood. Because of this, early intervention is the key to better diagnosing and treating the disorder in youth.

I’ve asked psychologist Dr. Vina Goghari to address some of the myths around psychotic disorders in youth. Dr. Goghari is an Associate Professor for the University of Calgary’s Department of Psychology.

“Precursor symptoms of psychosis can be confused with “difficult teen behaviour,” with the majority of youth who show these signs actually not going on to have a full-blown episode. So how should parents and families react?”

“I think that for parents, the main message is to not ignore. If you have a hunch about something that strikes you as unusual for your child, there’s nothing wrong with getting it checked out…We know that in some people during the first few years of the illness and even prior to the onset, people start to have changes happening in their brain – so if you can mitigate that through medication and other things, like psycho-social interventions and family psychoeducational groups, then that’ll help prevent or mitigate symptoms.”

“There’s a lot that we still don’t know about what causes psychosis. What has research told us so far?”

“In terms of what we do know – as your genetic relatedness to a person with schizophrenia increases, so does your risk…However, there are also a lot of environmental factors. Did your mom have the flu during the first half of her pregnancy? Did you grow up in a city or a rural place? Early birth complication are another risk factor. Even in schizophrenia, which is a widely-accepted as having strong biological and genetic risk factors, it’s not all biological and genetic. It’s not like Huntington’s or other single-gene disorders, where you have a certain chromosome affected. It’s much, much more complicated – likely combination of numerous genes and environmental factors interacting.”

“Drug-induced psychosis is a term that refers to temporary symptoms caused by using a certain substance. But many researchers have lately pointed to a link between cannabis use and a heightened risk of actually developing schizophrenia. Where does the science stand?”

“It’s a debate in the field; some people feel really strongly that it does; others are waiting for more replication, and others believe it depends on the concentration of the active ingredients. I just tell anyone that anytime you have a vulnerable brain, and you’re messing with neurotransmitters [brain chemistry], it’s probably not going to be the best thing for you…I would say that it’s better to stay away from it if you can, especially as it is not something that you need.”

“What are the biggest myths that cloud our understanding of psychosis and schizophrenia?”

“One of the theories of schizophrenia used to be that it was caused by schizophrenogenic mothers, mothers who were cold. And I think that because it’s such a severe disorder, that there’s still a lot of guilt in the families. I think it’s important to relate that most of the causes of schizophrenia tend to be factors that are more broad-based and not related to normal variations in parenting. Parents come in with all this guilt, the thought of what could they have done differently?

The other myth is that people with schizophrenia can’t recover or can’t have times when they function mostly normally…I think that’s another thing that can give people hope: the average person with schizophrenia [or psychosis] will have periods where they can function well. It won’t always be that they’re impacted to the same level.”

Dr. Vina Goghari is a Registered Psychologist, Associate Professor in the Department of Psychology and Researcher at the University of Calgary.