#ICD11

A wave of new research is prompting Thai psychiatrists and families to reconsider long-held beliefs about psychosis. Scientists are refining how we distinguish substance-induced psychosis from primary psychotic disorders, with implications for diagnosis, treatment, and hope for patients across Thailand.

Psychosis, a condition marked by a break from reality through hallucinations or delusions, has traditionally been split into two categories: primary psychosis, intrinsic to a psychiatric illness such as schizophrenia, and substance-induced psychosis, triggered by drugs or alcohol. Clear differentiation matters for care decisions, but until now gaps in understanding have complicated clinical judgments and family planning.

A wave of fresh research is prompting Thai psychiatrists and families to reconsider long-held assumptions about psychosis, as scientists explore the crucial differences between substance-induced and primary psychotic disorders. This emerging body of evidence, highlighted in a recent Medscape report, could help guide better diagnosis, tailored treatment, and more hopeful outcomes for patients across Thailand.

Psychosis, a condition marked by a loss of contact with reality—often via hallucinations or delusions—has long been categorized into those primarily caused by a psychiatric illness, like schizophrenia, and others triggered by substance use, such as methamphetamine (“ya ba”) or cannabis. Understanding whether symptoms are “primary” (intrinsic to psychiatric illness) or “substance-induced” (caused by drug or alcohol use) shapes every aspect of medical care, but until now, the true distinctions have often been blurred, fueling debates among clinicians and researchers worldwide.