In order to determine whether the diagnosis of a psychotic disorder is warranted, the health care professional has to first consider if a medical illness may be the cause of the behavioral changes. If a medical disease is identified or the psychosis is found to be the result of exposure to a medication or drug, the sufferer is assessed as having psychotic disorder due to a medical condition or psychotic disorder due to toxin exposure or withdrawal, respectively. On the other hand, if a medical cause and toxin exposure have been looked for and not found, a psychotic illness such as schizophrenia could be considered. The diagnosis will best be made by a licensed mental-health professional (like a psychiatrist or clinical psychologist), who can evaluate the patient and carefully sort through the diagnostic criteria for a variety of mental illnesses that might look alike at the initial examination, like schizotypal or schizoid personality disorder or a mood disorder with psychotic features like severe depression , or the mania phase of bipolar disorder. Other health care professionals who may treat psychotic disorders may include licensed social workers, psychiatric nurses and nurse practitioners, mental health physician assistants, and sometimes non-psychiatric physicians.
In summary, cigarette smoking and caffeine intake significantly impact the metabolism of a number of psychotropic medications and hence these factors should be routinely considered in prescribing decisions. While patients should be routinely encouraged to quit smoking they also need to be educated about the importance of informing their treating psychiatrist of changes in their caffeine intake or smoking. Research in new drug development should include studies to determine the impact of smoking and caffeine intake on dosages and clinical response.