What Is Psychosis? Causes, Symptoms And Treatment

This concept from psychiatry and clinical psychology is related to schizophrenia.


The word psychosis probably sounds familiar to a large majority of the population, or at least to those with knowledge of psychology and psychiatry.

It is a term that, although it was born around two centuries ago, is still used today when referring to certain mental disorders. Many people know that it is related to schizophrenia and other severe mental disorders.

So what is psychosis? In this article we are going to make a brief comment about it.

Psychoses: definition and associated symptoms

Psychosis is understood as the set of mental alterations that generate an alteration in the perception of reality in the person who suffers them, losing contact with it and causing severe difficulties in the functioning of perception, thought and behavior.

The concept emerged in the psychoanalytic current, appearing in 1841 and beginning to become popular from 1845. In fact, in this last year the division of mental disorders into neurosis (of neuropsychological origin, in which the subject has difficulties to adapt to reality but without denying it) and psychosis (psychiatric, in which there is a break with reality and a possible generation of a new one).

The most frequent and predominant symptoms that someone with some type of psychosis usually presents are hallucinations or perceptions of stimuli that do not exist in reality, which can affect any sensory modality, and delusions (whether or not these are an attempt to explain these hallucinations ).

It is also common for there to be an alteration in the ability to coordinate and organize thoughts, words and actions, losing the ability to make logical associations. Strange and disorganized behaviors are carried out, and on many occasions the thread of speech is lost. It is common for difficulties to concentrate, as well as the presence of alterations in mood. Agitation and panic, or on the contrary, total immobility, is not a strange phenomenon either.

Another aspect to take into account is that in most psychosis and psychotic experiences the subject is not aware of being affected by an alteration: he is obviously aware of what he perceives, but in general he does not initially see it as something self-generated if not as something that is actually happening. And they are not mere imaginations: the subject really perceives something (hears a voice, notices insects running through his body …), these perceptions simply do not correspond to real stimuli.

These alterations are usually linked to the suffering of a mental disorder, although they can also arise from the suffering of a brain injury, an organic pathology (a tumor or infection for example) or the consumption of substances (whether drugs or medications). But sometimes we can also present some type of psychotic symptom without having to suffer a specific problem or be intoxicated: there are some hallucinations that arise in periods of altered consciousness, or it is possible that starvation or lack of sleep can generate them.

The causes of psychoses

Psychoses are complex alterations, which throughout history have tried to be explained in multiple ways and by different theoretical currents. To this day, the causes of psychoses remain largely unknown, and the explanations raised can vary greatly depending on the psychotic disorder itself.

Currently, the most widespread hypothesis, of cognitive-behavioral origin, is that of diathesis-stress, in which it is considered that psychotic disorders are the product of the interaction of stressful vital factors and biological vulnerability generated by genetic inheritance and / or problems derived from brain function (such as poor neuronal migration or the presence of physiological alterations).

However, it must be borne in mind that different frameworks and currents of thought have offered different explanations. From Freudian psychoanalysis, for example, psychosis has been presented as a denial and substitution of the reality generated by the absence of the primary repressive capacity, specifying the subject of said deformation of reality in order to survive.

Another current that has tried to offer an explanation is the humanist, which proposes, for example, with the self-esteem map model that the core of the disorder is found in anguish and vulnerability to anti-exploits (defeats, failures and situations that make that the subject feels ashamed and self-deprecates), which end up causing the subject to deceive himself to protect himself and little by little to move away from reality.

However, both this model and the one based on psychoanalysis do not enjoy acceptance by the scientific community.

On the other hand, it must be taken into account that there is no consensus about whether psychosis constitutes in itself a psychological or psychiatric alteration that produces symptoms and problems in the way of thinking and interacting with the environment; It could be a set of consequences triggered by very varied problems, both biological and psychological, and which have been grouped under the same name due to a superficial resemblance.

Some psychotic disorders

Psychosis is a generic term that refers to the general functioning of these types of disorders. But in reality there are a lot of different psychopathologies that fall into this category. Also, some disorders that were originally identified as psychotic have subsequently been separated from this concept. An example is bipolar disorder, formerly called manic-depressive psychosis. Some of the major psychotic disorders are listed below.

1. Schizophrenia

The best known and prototypical of psychotic disorders, schizophrenia is a disorder in which hallucinations, delusions and language disturbances often appear. Disorganized behavior, catatonia, or negative symptoms such as poor thinking and judgment may also appear. It generally occurs in the form of outbreaks and creates a great deal of difficulties for the sufferer. Symptoms last at least six months and can end up causing cognitive decline.

2. Chronic delusional disorder

Another of the major psychotic-type mental disorders, chronic delusional disorder is characterized by the existence of alterations in the content of thought, with strange beliefs that do not conform to reality that remain fixed despite the evidence to the contrary. In general, with the exception of what is linked to the content of her delusion, the subject acts normally and does not present other difficulties. Beliefs can be more or lessmaticsmatized, and the subject often considers that the evidence supports her beliefs and ignores those elements that contradict them.

3. Schizophreniform disorder

It is a psychotic type disorder that shares most of the symptoms with schizophrenia, except for the fact that the duration of its symptoms is more than one month but less than six and does not cause deterioration.

4. Schizoaffective disorder

This disorder is characterized by the presence of psychotic symptoms together with mood alterations such as depressive or manic episodes, with psychotic symptoms existing for at least two weeks in the absence of manic or depressive episodes (otherwise we could be dealing with a depressive disorder or bipolar with psychotic characteristics).

5. Brief reactive psychosis

Brief appearance of psychotic symptoms as a reaction to a stressful and traumatic phenomenon.

6. Psychotic disorder due to medical illness

Some medical illnesses can end up generating psychotic symptoms due to the involvement of the nerves or the brain. Dementias, tumors, autoimmune problems and metabolic disorders can be the origin of an organic psychosis.

7. Psychotic disorder derived from substance use

Drugs can also generate psychotic experiences, both at the time of consumption and in intoxication or as a result of withdrawal syndrome in dependent subjects.

8. Brief psychotic disorder

It is a psychotic disorder similar to schizophrenia and schizophreniform disorder, with the difference that in this case it lasts less than one month.

9. Occasional symptom in other disorders

It must be borne in mind that in addition to the psychotic disorders themselves, many other psychopathologies can present with some psychotic elements. This is what happens with depression or bipolar disorder, in which hallucinations and psychotic phenomena can occasionally appear.

Bibliographic references:

  • Cardinal, RN; Bullmore, ET (2011). The Diagnosis of Psychosis. Cambridge: Cambridge University Press.
  • Cannon, BJ; Kramer, LM (2011). Delusion content across the 20th century in an American psychiatric hospital. International Journal of Social Psychiatry. SAGE Publications. 58 (3): 323–327.
  • Johns, LC; van Os, J. (2001). The continuity of psychotic experiences in the general population. Clinical Psychology Review, 21 (8): pp. 1125-1141.
  • Lesser, JM; Hughes, S. (2006). “Psychosis-related disturbances. Psychosis, agitation, and disinhibition in Alzheimer’s disease: definitions and treatment options”. Geriatrics. 61 (12): 14–20.
  • Read, J .; van Os, J .; Morrison, AP; Ross, CA (2005). Childhood trauma, psychosis and schizophrenia: a literature review with theoretical and clinical implications. Acta Psychiatrica Scandinavica, 112 (5): pp. 330-350.
  • Tsuang, MT; William, S. Stone, SV Faraone (2000). Toward Reformulating the Diagnosis of Schizophrenia. American Journal of Psychiatry, 157 (7): pp. 1041-1050.

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