What is psychosis? Causes, symptoms and treatment

This concept of 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 about 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? what is psychosis? In this article we are going to make a brief commentary about it.

Psychosis: definition and associated symptoms

Psychosis is understood as the set of mental alterations that generate in the sufferer an alteration in the perception of reality, 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 becoming popular from 1845 onwards. In fact, in the latter year the division of mental disorders into neurosis (of neuropsychological origin, in which the subject has difficulty adapting 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) would become popular and widespread.

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

It is also common that there is 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 in many occasions the thread of the speech is lost. Difficulties in concentrating are common, as well as the presence of alterations in mood. Agitation and panic, or on the contrary, total immobility, is not an uncommon phenomenon.

Another aspect to take into account is that in most psychoses and psychotic-type experiences the subject is not aware that he/she is suffering from a disturbance: he/she is obviously aware of what he/she perceives, but usually does not see it initially as something self-generated but as something that is really happening. And these are not mere imaginations: the subject really perceives something (he 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 mental disorder. they can also arise from the suffering of a cerebral lesion, an organic pathologyThey can also arise from a brain injury, an organic pathology (a tumor or infection, for example) or the consumption of substances (whether drugs or medicines). But sometimes we can also present some type of psychotic symptom without the need to suffer from 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 psychosis

Psychoses are complex disorders, which throughout history have tried to be explained in multiple ways and by different theoretical currents. Today, the causes of psychosis the causes of psychoses are still largely unknown, with the causes varying to a great extent.The explanations put forward vary greatly depending on the psychotic disorder itself.

At present, the most widespread hypothesis, of cognitive-behavioral origin, is that of diathesis-stress. the diathesis-stress hypothesisThe authors of this paper consider that psychotic disorders are the result of the interaction of stressful life factors and Biological vulnerability generated by genetic inheritance and/or problems derived from brain functioning (such as poor neuronal migration or the presence of physiological alterations).

However, it should be noted 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 reality generated by the absence of the capacity for primary repression, the subject needing this deformation of reality in order to survive.

Another current that has tried to offer an explanation is the humanistic one, which proposes, for example, with the self-esteem map model that the core of the disorder is found in anguish and vulnerability to anti-doings (defeats, failures and situations that make the subject feel ashamed and self-deprecating), which end up causing the subject to self-deception to protect him/herself and gradually move away from reality.

However, both this model and the one based on psychoanalysis are not accepted by the scientific community.

On the other hand, it must be taken into account that there is no consensus as to whether psychosis in itself constitutes a psychological or psychiatric disorder that produces symptoms of psychosis. and problems in the way of thinking and interacting with the environment; it could be a set of consequences triggered by a wide variety of problems, both biological and psychological, 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 this type of disorder. But in reality there are a large number of different psychopathologies that fall into this category.. Also, some disorders that were originally identified as psychotic have subsequently been separated from this concept. One example is bipolar disorder, formerly called manic-depressive psychosis. Some of the major psychotic disorders are arranged below.

1. Schizophrenia

The best known and most prototypical of the psychotic disorders, schizophrenia is a disorder in which hallucinations, delusions and language disturbances often occur.. Disorganized behavior, catatonia, or negative symptoms such as impoverished thinking and judgment may also appear. It usually occurs in the form of outbreaks and generates a great deal of difficulties for the sufferer. The symptoms last at least six months and can eventually lead to cognitive impairment.

2. Chronic delusional disorder

Another of the great mental disorders of psychotic type, the chronic delusional disorder is characterized by the existence of alterations in the content of thoughtThere are bizarre beliefs that do not conform to reality and that remain fixed despite evidence to the contrary. In general, with the exception of what is linked to the content of his delirium, the subject acts normally and does not present other difficulties. Beliefs may be more or less systematized, and the subject often considers that the evidence supports his beliefs and ignores those elements that contradict them.

3. Schizophreniform Disorder

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

4. Schizoaffective disorder

This disorder is characterized by the presence of psychotic symptomatology together with alterations of the state of the mood like depressive or manic episodespsychotic symptoms for at least two weeks in the absence of manic or depressive episodes (otherwise we could be dealing with a depressive or bipolar disorder with psychotic features).

5. Brief reactive psychosis

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

6. Psychotic disorder due to medical illness

Some medical illnesses can eventually generate psychotic symptomatology due to the involvement of nerves or the brain.. Dementias, tumors, autoimmune problems and metabolic alterations 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 during intoxication or as a result of withdrawal syndrome. as a result of the withdrawal syndrome in dependent subjects.

8. Brief psychotic disorder

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

9. Occasional symptom in other disorders

It should be noted that in addition to the psychotic disorders themselves, many other psychopathologies can also present other psychopathologies can present with some psychotic elements.. This is the case with depression or bipolar disorder, in which hallucinations and psychotic phenomena may occasionally appear.

Bibliographical references:

• Cardinal, R.N.; Bullmore, E.T. (2011). The Diagnosis of Psychosis. Cambridge: Cambridge University Press.
• Cannon, B.J.; Kramer, L.M.. (2011). Delusion content across the 20th century in an American psychiatric hospital. International Journal of Social Psychiatry. SAGE Publications. 58 (3): 323-327.
• Johns, L.C.; van Os, J. (2001). The continuity of psychotic experiences in the general population. Clinical Psychology Review, 21(8): pp. 1125 - 1141.
• Lesser, J.M.; 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, A.P.; Ross, C.A. (2005). Childhood trauma, psychosis and schizophrenia: a literature review with theoretical and clinical implications. Acta Psychiatrica Scandinavica, 112(5): pp. 330 - 350.
• Tsuang, M.T.; William, S. Stone, S.V. Faraone (2000). Toward Reformulating the Diagnosis of Schizophrenia. American Journal of Psychiatry, 157(7): pp. 1041 - 1050.