What is psychosis? Causes, symptoms and treatment

The word psychosis probably seems to be intended for a large majority of the population, or at least for those familiar with psychology and psychiatry.

It is a term which, although it originated about two centuries ago, is still used today to refer to certain mental disorders. Many people know it is linked to schizophrenia and other serious mental disorders.

Therefore, What is psychosis? In this article, we will make a brief commentary on this.

    Psychosis: definition and associated symptoms

    It is understood by psychosis in the set of mental disorders which generate in those who undergo them an alteration of the perception of reality, losing contact with it and causing serious difficulties in the functioning of perception, thought and behavior.

    The concept was born in the psychoanalytic stream, appearing in 1841 and starting to become popular from 1845. In fact, in this last year the division of mental disorders into neurosis would become popular and spread (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 possible generation of a new one).

    The most common and common symptoms in a person with a certain type of psychosis are hallucinations or perceptions of stimuli that do not exist in reality, Which can affect any sensory modality and delusions (whether or not it is an attempt to explain these hallucinations).

    It is also common for there to be an impaired ability to coordinate and organize thoughts, words and actions, losing the ability to make logical associations. Weird and disorganized behaviors are performed, And in many cases the thread of the speech is lost. It is common to have difficulty concentrating, as well as the presence of mood swings. Restlessness and panic, or on the contrary total immobility, are not a strange phenomenon either.

    Another aspect to keep in mind is that in most psychoses and psychotic experiences, the subject is not aware that he is suffering from an alteration: he is obviously aware of what he perceives, but does not see it. usually not initially as something self-generated if not as something really happening. And these are not simple imaginations: the subject really perceives something (being a voice, he notices insects which roam his body …), simply these perceptions do not correspond to real stimuli.

    These disorders are often linked to suffering from a mental disorder, however they can also result from brain damage, An organic pathology (a tumor or an infection for example) or the consumption of substances (whether they are drugs or drugs). But sometimes we can also present some kind of psychotic symptom without having to suffer from a specific problem or be intoxicated: there are hallucinations that occur during periods of altered consciousness, or it is possible that starvation or lack sleep can generate them.

    The causes of psychosis

    Psychoses are complex alterations which, throughout history, have tried to be explained in multiple ways and by different theoretical currents. Today the causes of psychosis remain largely unknown, Be able to vary to a large extent the explanations raised depending on the psychotic disorder itself.

    At present, the most widespread hypothesis, of cognitive-behavioral origin, is that of diathesis-stress, Wherein psychotic disorders are considered to be the product of the interaction of vital stressors 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 should be noted that different frameworks and schools of thought have offered different explanations. From Freudian psychoanalysis, for example, psychosis has been presented as a denial and a substitution of reality generated by the absence of the capacity for primary repression, specifying the subject of this distortion of reality in order to survive.

    Another current that has tried to offer an explanation is the humanist, who proposes for example with the cartographic model of self-esteem that the heart of the disorder is in anguish and vulnerability to anti-exploits (defeats, failures and situations that make the subject feel ashamed and belittle himself), which ends up causing the subject to deceive himself in order to protect himself and gradually move away from reality.

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

    On the other hand, it should be noted that there is no consensus on whether psychosis is itself a psychological or psychiatric disorder that produces symptoms and issues in the way we think about and interact with the environment; it can be a set of consequences triggered by a wide variety of problems, both biological and psychological, which have been lumped together under one name because of a superficial resemblance.

    Certain psychotic disorders

    Psychosis is a generic term for the general functioning of this type of disorder. But really there are many different psychopathologies that fall into this category. Likewise, certain disorders initially identified as psychotic were subsequently separated from this concept. One example is bipolar disorder, formerly known as manic depression. Here are some of the main psychotic disorders.

    1. Schizophrenia

    The best known and most typical of psychotic disorders, schizophrenia is a disorder in which hallucinations, delusions and language changes often appear. Disorganized behavior, catatonia, or negative symptoms such as poor thinking and judgment may also appear. This usually happens in the form of epidemics and creates a lot of hardship for those who suffer from it. Symptoms last at least six months and can eventually cause cognitive impairment.

      2. Chronic delusional disorder

      Another of the major mental disorders of the psychotic type, chronic delusional disorder is characterized by the existence of alterations in thought contentExisting strange beliefs that do not conform to reality remain frozen despite evidence to the contrary. In general, with the exception of what is related to the content of his delirium, the subject acts normally and presents no other difficulties. Beliefs can be more or less systematized, and the subject often considers the evidence to support their beliefs and ignores the elements that contradict them.

      3. Schizophreniform disorder

      It is a psychotic disorder that shares most of the symptoms of schizophrenia, except that the duration of his symptoms is more than one month but less than six and not cause deterioration.

        4. Schizoaffective disorder

        This disorder is characterized by the presence of psychotic symptoms accompanied by mood swings such as depressive or manic episodes, Psychotic symptoms existing for at least two weeks in the absence of manic or depressive episodes (otherwise we might be dealing with depressive or bipolar disorder with psychotic features).

        5. Brief reactive psychosis

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

        6. Psychotic disorder due to medical illness

        Certain medical illnesses can end up generating psychotic symptoms. due to nerve or brain damage. Dementias, tumors, autoimmune problems and metabolic disorders can cause psychosis organic.

        7. Psychotic disorder related to substance use

        Drugs can also lead to psychotic experiences, both at the time of consumption and intoxication or following abstinence syndrome in dependent subjects.

        8. Brief psychotic disorder

        It’s a psychotic disorder similar to schizophrenia and schizophreniform disorders, With the difference that in this case, it lasts less than a month.

        9. Occasional symptom of other disorders

        It should be noted that in addition to actual psychotic disorders, many other psychopathologies may work with certain psychotic elements. This is what happens with depression or bipolar disorder, in which hallucinations and psychotic phenomena can sometimes appear.

        Bibliographical references:

        • Cardinal, RN; Bullmore, ET (2011). The diagnosis of psychosis. Cambridge: Cambridge University Press.
        • Cannon, BJ; Kramer, LM (2011). Content of illusions throughout the twentieth 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. Journal of Clinical Psychology, 21 (8): pages 1125-1141.
        • Minor, JM; Hughes, S. (2006). “Psychosis-Related Disorders. 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, California (2005). Childhood trauma, psychosis and schizophrenia: a review of the literature with theoretical and clinical implications. Acta Psychiatrica Scandinavica, 112 (5): pp. 330 – 350.
        • Tsuang, MT; William, S. Stone, SV Pharaoh (2000). Towards the reformulation of the diagnosis of schizophrenia. American Journal of Psychiatry, 157 (7): pages 1041-1050.

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