Interview with Drs. André Barciela Veras and Jeffrey Paul Kahn, MD, authors of Psychotic Disorders, 1st Edition

Why did you feel that it was important to write Psychotic Disorders and what does it add to the field?  

Psychotic disorders are the most severe, painful and disabling conditions in psychiatry.  It is essential to move beyond solitary psychotic symptoms and overly broad psychotic diagnoses to more refined, explanatory, treatable and specific diagnoses.  In any branch of medicine, specific diagnosis is essential for effective treatment.    

Ongoing research may suggest a counterintuitive and novel approach to the long-sought goal of subtyping schizophrenia and other psychotic disorders.  Five psychosis-associated anxiety and depressive subtypes each help define five corresponding psychosis diagnoses, their fixed false beliefs, and most importantly, their treatments.

Anxiety and depressive comorbidities have long been long seen merely as an understandable hodgepodge of distressing symptoms caused by the pain of psychosis.  But these five comorbidities usually precede onset of the psychosis, and their treatment can significantly improve outcome. So, just maybe, the causation is the other way around: maybe they are among the underlying contributors to schizophrenia and other psychotic disorders. 

What is the most exciting aspect of your new publication?  What chapter or topic covered in the new edition are you most excited about?  

The book provides a novel diagnostic schema, more specific diagnoses, improved treatment approaches, and supporting research data.  The text includes specific interviewing approaches for the five comorbidities in psychosis patients, novel clinical perspective, illustrative cases, and DSM-5 diagnostic criteria.  Additional chapters explore psychoses related to substance use, medical illness and medical treatment, as well as other factors that contribute to psychotic disorders. The book is a compelling synthesis of clinical experience and recent research literature. The resulting diagnostic and treatment approaches are the most exciting feature of this book. 

One especially exciting example is that voices (auditory hallucinations) may actually be psychotic panic attacks.  

Who will find the greatest value from this book and why?  

This first-of-its-kind reference is a valuable clinical, educational, research and training resource for psychiatrists, psychologists, nurses, social workers, neurologists and anyone interested in the care, treatment and study of patients with psychotic disorders. 

What new ideas, practices, or procedures do you hope your readers take away from Psychotic Disorders?  

• There are specific subtypes of psychosis 
• Anxiety and depression symptoms are not mere artifacts of psychosis 
• Five psychosis subtypes are associated with five specific and preceding anxiety and depressive comorbidities 
• The five psychosis subtypes may be psychotic versions of the comorbid syndromes. 
• Specific diagnostic and interview approaches are needed for each subtype 
• Specific treatment approaches are more effective for each subtype 
• Proper diagnosis and treatment improve outcome 
• Specific psychosis symptoms can be understood as psychotic versions of the comorbidity symptoms 

What problem do you hope the future generation of your specialty will be able to solve?  

Hopefully, future psychosis research can expand and integrate knowledge of neuroimaging, genetics, neurochemistry, symptoms, diagnosis, treatment and prognosis.  Moreover, early treatment of some of the comorbidities could help prevent psychosis onset. 

André Barciela Veras, MD, PhD, Psychiatrist and Professor at the Medical School of the State University of Mato Grosso do Sul. 

Jeffrey Paul Kahn, MD, Clinical Professor of Psychiatry at Weill-Cornell Medical College, Cornell University, New York, New York.  Though mostly a practicing psychiatrist, his academic work has included psychosis, anxiety disorders, diagnosis, heart disease, evolutionary psychiatry, and psychiatric aspects of work, career and organizations.  He completed medical school, psychiatric residency, and research fellowship training at Columbia University. 

Psychotic Disorders: Comorbidity Detection Promotes Improved Diagnosis and Treatment, 1^st Edition offers a counterintuitive and novel approach to the long-sought goal of subtyping schizophrenia and other psychotic disorders. Get your copy here.