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For other uses, see Psychosis (disambiguation).
Psychosis
Classification and external resources
ICD-9 290-299
OMIM 603342 608923 603175 192430
MedlinePlus 001553
MeSH F03.700.675

Psychosis is a generic psychiatric term for a mental state often described as involving a "loss of contact with reality. The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify Diseases The following is a list of codes for International Statistical Classification of Diseases and Related Health Problems. The Mendelian Inheritance in Man project is a Database that catalogues all the known Diseases with a genetic component, and—when possible—links them MedlinePlus, with the MedlinePlus Medical Encyclopedia, is a website network containing Health information from the world's largest medical Library Medical Subject Headings ( MeSH) is a huge Controlled vocabulary (or metadata system for the purpose of indexing journal articles and books Psychiatry is a medical specialty which exists to study, prevent, and treat Mental disorders in Humans Psychiatric The mental status examination (or mental state examination in the UK and Australia abbreviated MSE, is an important part of the clinical assessment process Reality, in everyday usage means "the state of things as they actually exist" " People suffering from it are said to be psychotic.

People experiencing psychosis may report hallucinations or delusional beliefs, and may exhibit personality changes and disorganized thinking. A hallucination, in the broadest sense is a Perception in the absence of a stimulus. A delusion is commonly defined as a fixed False Belief and is used in everyday language to describe a belief that is either false fanciful or derived from Deception In Psychiatry, thought disorder or formal thought disorder is a term used to describe a pattern of disordered language use that is presumed to reflect disordered thinking This may be accompanied by unusual or bizarre behaviour, as well as difficulty with social interaction and impairment in carrying out the activities of daily living.

A wide variety of nervous system stressors, both organic and functional, can cause a psychotic reaction. This has led to the belief that psychosis is the 'fever' of mental illness—a serious but nonspecific indicator. [1][2]

However, many people have unusual and reality-distorting experiences at some point in their lives, without being impaired or even distressed by these experiences. For example, many people have experienced visions of some kind, and some have even found inspiration or religious revelation in them. In Spirituality including Religion, visions comprise Inspirational renderings generally of a Future state and/or of a mythical Revelation is the act of revealing or disclosing (see etymology or in the theological perception making something obvious and clearly understood through active or passive communication [3] As a result, it has been argued that psychosis is not fundamentally separate from normal consciousness, but rather, is on a continuum with normal consciousness. [4] In this view, people who are clinically found to be psychotic may simply be having particularly intense or distressing experiences (see schizotypy). Schizotypy is a psychological concept which describes a continuum of personality characteristics and experiences related to Psychosis and in particular

In contemporary culture, the term "psychotic" is often incorrectly used interchangeably with psychopath. Psychopathy ( is a psychological construct that describes chronic immoral and Antisocial behavior

Contents

Signs and symptoms

People with psychosis may have one or more of the following:

Hallucinations

Hallucinations are defined as sensory perception in the absence of external stimuli. A hallucination, in the broadest sense is a Perception in the absence of a stimulus. They are different from illusions, or perceptual distortions, which are the misperception of external stimuli. An illusion is a distortion of the senses revealing how the Brain normally organizes and interprets sensory stimulation [5] Hallucinations may occur in any of the five senses and take on almost any form, which may include simple sensations (such as lights, colors, tastes, and smells) to more meaningful experiences such as seeing and interacting with fully formed animals and people, hearing voices and complex tactile sensations.

Auditory hallucinations, particularly the experience of hearing voices, are a common and often prominent feature of psychosis. Hallucinated voices may talk about, or to the person, and may involve several speakers with distinct personas. Auditory hallucinations tend to be particularly distressing when they are derogatory, commanding or preoccupying. However, the experience of hearing voices need not always be a negative one. Research has shown that the majority of people who hear voices are not in need of psychiatric help. [6] The Hearing Voices Movement has subsequently been created to support voice hearers, regardless of whether they are considered to have a mental illness or not. Hearing Voices Movement is a philosophical trend in how people who hear voices are viewed

Delusions

Psychosis may involve delusional beliefs, some of which are paranoid in nature. A delusion is commonly defined as a fixed False Belief and is used in everyday language to describe a belief that is either false fanciful or derived from Deception Paranoia is a disturbed thought process characterized by excessive Anxiety or Fear, often to the point of Irrationality and Delusion. Karl Jaspers classified psychotic delusions into primary and secondary types. Karl Theodor Jaspers ( February 23, 1883 – February 26, 1969) was a German Psychiatrist and Philosopher who Primary delusions are defined as arising out of the blue and not being comprehensible in terms of normal mental processes, whereas secondary delusions may be understood as being influenced by the person's background or current situation (e. g. , ethnic or sexual orientation, religious beliefs, superstitious belief). [7]

Thought disorder

Formal thought disorder describes an underlying disturbance to conscious thought and is classified largely by its effects on speech and writing. In Psychiatry, thought disorder or formal thought disorder is a term used to describe a pattern of disordered language use that is presumed to reflect disordered thinking Affected persons may show pressure of speech (speaking incessantly and quickly), derailment or flight of ideas (switching topic mid-sentence or inappropriately), thought blocking, and rhyming or punning. Intrusive thoughts are unwelcome involuntary thoughts images or unpleasant ideas that may become obsessions, are upsetting or distressing and can be difficult to be free of

Lack of insight

One important and puzzling feature of psychosis is usually an accompanying lack of insight into the unusual, strange, or bizarre nature of the person's experience or behaviour. [8] Even in the case of an acute psychosis, people may be completely unaware that their vivid hallucinations and impossible delusions are in any way unrealistic. This is not an absolute, however; insight can vary between individuals and throughout the duration of the psychotic episode.

It was previously believed that lack of insight was related to general cognitive dysfunction[9] or to avoidant coping style. [10] Later studies have found no statistical relationship between insight and cognitive function, either in groups of people who only have schizophrenia,[11] or in groups of psychotic people from various diagnostic categories. Schizophrenia ( from the Greek roots schizein (σχίζειν "to split" and phrēn [12]

Classification

In medical practice today, a descriptive approach to psychosis (and to all mental illness) is used, based on behavioral and clinical observations. Behavior or behaviour (see spelling differences) refers to the actions or Reactions of an object or Organism, usually Medicine is the art and science of healing It encompasses a range of Health care practices evolved to maintain and restore Human Health by the This approach is adopted in the standard guide to psychiatric diagnoses employed in the United States, the Diagnostic and Statistical Manual of Mental Disorders (DSM). The Diagnostic and Statistical Manual of Mental Disorders' ( DSM) is published by the American Psychiatric Association Since the DSM provides a widely-used standard of reference, the description presented here will largely reflect that point of view.

According to the DSM-IV-TR, the term psychosis has had many definitions in the past, both broad and narrow. The Diagnostic and Statistical Manual of Mental Disorders' ( DSM) is published by the American Psychiatric Association The broadest was not being able to meet the demands of everyday life. The narrowest was delusions or hallucinations without insight. A middle ground may be delusions, hallucinations with or with out insight, and well as disorganized behavior or speech. Thus, psychosis can be a symptom of mental illness, but it is not a mental illness in its own right. A symptom' (from Greek σύμπτωμα, "accident misfortune that which befalls" from συμπίπτω, "I befall" from For example, people with schizophrenia often experience psychosis, but so can people with bipolar disorder (manic depression), unipolar depression, delirium, or drug withdrawal. Schizophrenia ( from the Greek roots schizein (σχίζειν "to split" and phrēn Major depressive disorder, also known as major depression, unipolar depression, unipolar disorder, clinical depression, or simply depression Delirium is an acute and relatively sudden (developing over hours to days decline in attention-focus perception and Cognition. Withdrawal, also known as withdrawal/abstinence syndrome, refers to the characteristic signs and symptoms that appear when a drug that causes Physical dependence is [13][1] People diagnosed with these conditions can also have long periods without psychosis, and some may never experience them again. Conversely, psychosis can occur in people who do not have chronic mental illness (e. g. due to an adverse drug reaction or extreme stress). [14]

Psychosis should be distinguished from:

The DSM-IV-TR lists 9 formal psychotic disorders, but many other disorders may have psychotic symptoms. The formal psychotic disorders are:

Causes

Causes of symptoms of mental illness were customarily classified as "organic" or "functional". Organic conditions were primarily medical or pathophysiological, whereas, functional conditions are primarily psychiatric or psychological. Pathophysiology is the study of the disturbance of normal Mechanical, Physical, and Biochemical functions either caused by a Disease, or resulting The DSM-IV-TR no longer classifies psychotic disorders as functional or organic. Rather it lists traditional psychotic illnesses, psychosis due to General Medical conditions, and Substance induced psychosis.

Psychiatric

Functional causes of psychosis include the following:

A psychotic episode can be significantly affected by mood. Schizophrenia ( from the Greek roots schizein (σχίζειν "to split" and phrēn Major depressive disorder, also known as major depression, unipolar depression, unipolar disorder, clinical depression, or simply depression The term psychosocial refers to one in Psychological development in and interaction with a Social environment. Sleep deprivation is a general lack of the necessary amount of Sleep. Epilepsy is a common chronic Neurological disorder that is characterized by recurrent unprovoked seizures. The temporal lobes are parts of the cerebrum that are involved in speech, Memory, and Hearing. For example, people experiencing a psychotic episode in the context of depression may experience persecutory or self-blaming delusions or hallucinations, while people experiencing a psychotic episode in the context of mania may form grandiose delusions.

Stress is known to contribute to and trigger psychotic states. A history of psychologically traumatic events, and the recent experience of a stressful event, can both contribute to the development of psychosis. Short-lived psychosis triggered by stress is known as brief reactive psychosis, and patients may spontaneously recover normal functioning within two weeks. Brief reactive psychosis is the psychiatric term for Psychosis which can be triggered by an extremely stressful event in the life of a patient [14] In some rare cases, individuals may remain in a state of full-blown psychosis for many years, or perhaps have attenuated psychotic symptoms (such as low intensity hallucinations) present at most times.

Sleep deprivation has been linked to psychosis. [20][21][22] However, this is not a risk for most people, who merely experience hypnagogic or hypnopompic hallucinations, i. Hypnagogia ( Greek ὕπνος húpnos "sleep" + the root found in ἄγω ágō "to lead away conduct convey" ἀγωγεύς A hypnopompic state (or hypnopomp) is the state of consciousness leading out of sleep a term coined by the spiritualist Frederick Myers e. unusual sensory experiences or thoughts that appear during waking or drifting off to sleep. These are normal sleep phenomena and are not considered signs of psychosis. [23]

General medical

Psychosis arising from "organic" (non-psychological) conditions is sometimes known as secondary psychosis. It can be associated with the following pathologies:

Psychosis can even be caused by apparently innocuous ailments such as flu[53][54] or mumps. Pathology (from Greek grc πάθος pathos, "fate harm" and grc -λογία -logia) is the study and A brain tumor is any intracranial Tumor created by abnormal and uncontrolled cell division, normally either in the Brain itself ( Neurons Dementia with Lewy bodies (DLB is a type of Dementia characterized by abnormal levels of Lewy bodies, a nervous system protein Multiple sclerosis (abbreviated MS also known as disseminated sclerosis or encephalomyelitis disseminata) is an autoimmune condition in which the Sarcoidosis, also called sarcoid (from the Greek sarx, meaning "flesh" or Besnier-Boeck disease, is an immune system disorder characterized Lyme disease, or borreliosis, is an Emerging infectious disease caused by at least three Species of Bacteria belonging to the Genus Syphilis is a Sexually transmitted disease caused by the spirochetal Bacterium Treponema pallidum pallidum. Alzheimer's disease ( AD) also called Alzheimer disease or simply Alzheimer's, is the most common form of Dementia. Parkinson's disease (also known as Parkinson disease or PD) is a degenerative disorder of the Central nervous system that often impairs the sufferer's In Medicine, hypocalcaemia is the presence of low serum Calcium levels in the Blood, usually taken as less than 2 Hypernatremia is an Electrolyte disturbance that is defined by an elevated Sodium level in the blood Hyponatremia ( British: hyponatraemia) is an Electrolyte disturbance (disturbance of the salts in the blood in which the Sodium ( Natrium Hypokalemia refers to the condition in which the concentration of Potassium in the blood is low The prefix hypo- means low (contrast with hyper- meaning high Hypermagnesemia is an Electrolyte disturbance in which there is an abnormally elevated level of Magnesium in the blood Hypercalcaemia (in American English '''Hypercalcemia''' is an elevated calcium level in the Blood. Hypophosphatemia is an Electrolyte disturbance in which there is an abnormally low level of Phosphate in the Blood. Hypoglycemia or hypoglycaemia is the medical term for a pathologic state produced by a lower than normal level of Glucose ( sugar) in the blood Systemic lupus erythematosus ( SLE or lupus,) is a chronic autoimmune disease that can be fatal though with recent medical advances fatalities are becoming Leprosy (from the Greek lepi (λέπι meaning scales on a fish or Hansen's disease, is a chronic disease caused by the bacterium Malaria is a vector -borne Infectious disease caused by Protozoan Parasites It is widespread in tropical and subtropical regions including Leukoencephalopathy with vanishing white matter (VWM disease is an Autosomal recessive neurological disease Metachromatic leukodystrophy ( MLD, also called Arylsulfatase A deficiency) is the most common form of a family of genetic diseases known as the Leukodystrophies Mumps or epidemic Parotitis is a Viral disease of the Human species [55]

Substance use

Psychotic states may occur after ingesting a variety of substances both legal and illegal and both prescription and non prescription. Psychoactive drug intoxication or withdrawal. A psychoactive drug or psychotropic substance is a Chemical substance that acts primarily upon the Central nervous system where it alters Brain Intoxication is the state of being affected by one or more psychoactive drugs. Withdrawal, also known as withdrawal/abstinence syndrome, refers to the characteristic signs and symptoms that appear when a drug that causes Physical dependence is Drugs whose use, abuse or withdrawal are implicated include:

Intoxication with drugs that have general depressant effects on the central nervous system (especially alcohol and barbiturates) tend not to cause psychosis during use, and can actually decrease or lessen the impact of symptoms in some people. Phenylpropanolamine (PPA is a drug ingredient of the Phenethylamine family used as a Decongestant in prescription and nonprescription (over the counter Barbiturates are drugs that act as central nervous system Depressants and by virtue of this they produce a wide spectrum of effects from mild Sedation The benzodiazepines (pronounced, often abbreviated to "benzos") are a class of Psychoactive drugs with varying Hypnotic Isotretinoin ( INN) (aɪsoʊtrɨˈtɪnoʊɨn or /ˌaɪsoʊtrɨˈtɪnoʊɨn/ is a Medication used for the treatment of severe acne. Atropine is a Tropane Alkaloid extracted from Deadly nightshade ( Atropa belladonna) Jimsonweed (Datura stramonium and other plants The fictional truth drug Hyoscine-pentothal does not describe real hyoscine accurately Jimsonjade, known by the Common names jimson weed, ditch weed, Good weed, loco weed, Korean morning glory An antidepressant is a Psychiatric medication used for alleviating major depression or Dysthymia ('milder' depression The anticonvulsants, also called antiepileptic drugs (abbreviated "AEDs" are a diverse group of pharmaceuticals used in the treatment of epileptic Amphetamine, and related drugs such as Methamphetamine are a group of drugs that act by increasing levels of Norepinephrine, Serotonin, and Dopamine Cocaine ( benzoylmethyl ecgonine) is a Crystalline Tropane Alkaloid that is obtained from the leaves of the Coca plant MDMA ( 34-methylenedioxy- N -methylamphetamine) most commonly known today by the street name Ecstasy (often abbreviated E, X, In Vertebrates the central nervous system ( CNS) is the part of the Nervous system which is enclosed in the Meninges. However, withdrawal from barbiturates and alcohol can be particularly dangerous, leading to psychosis or delirium and other, potentially lethal, withdrawal effects.

Some studies indicate that cannabis use may lower the threshold for psychosis, and thus help to trigger full-blown psychosis in some people. Cannabis, also known as marijuana or marihuana, or ganja (from Hindi / Sanskrit: गांजा gānjā hemp) is a [76] Early studies have been criticized for failing to consider other drugs (such as LSD) that the participants may have used before or during the study, as well as other factors such as pre-existing ("comorbid") mental illness. However, more recent studies with better controls have still found a small increase in risk for psychosis in cannabis users. [77]

It is not clear whether this is a causal link, and it is possible that cannabis use only increases the chance of psychosis in people already predisposed to it; or that people with developing psychosis use cannabis to provide temporary relief of their mental discomfort. The fact that cannabis use has increased over the past few decades, whereas the rate of psychosis has not, suggests that a direct causal link is unlikely for all users. [78]

Pathophysiology

Brain imaging studies of psychosis, investigating both changes in brain structure and changes in brain function of people undergoing psychotic episodes, have shown mixed results. Neuroimaging includes the use of various techniques to either directly or indirectly image the structure, function/ Pharmacology of the Brain

The first brain image of an individual with psychosis was completed as far back as 1935 using a technique called pneumoencephalography[79] (a painful and now obsolete procedure where cerebrospinal fluid is drained from around the brain and replaced with air to allow the structure of the brain to show up more clearly on an X-ray picture). Pneumoencephalography (sometimes abbreviated PEG is a Medical procedure in which Cerebrospinal fluid is drained to a small amount from around the Brain Cerebrospinal fluid ( CSF) Liquor cerebrospinalis, is a clear Bodily fluid that occupies the Subarachnoid space and the Ventricular system X-radiation (composed of X-rays) is a form of Electromagnetic radiation.

More recently, a 2003 study investigating structural changes in the brains of people with psychosis showed there was significant grey matter reduction in the cortex of people before and after they became psychotic. The cerebral cortex is a structure within the Brain that plays a key role in Memory, Attention, perceptual Awareness, Thought, [80] Findings such as these have led to debate about whether psychosis is itself neurotoxic and whether potentially damaging changes to the brain are related to the length of psychotic episode. Neurotoxicity occurs when the exposure to natural or artificial toxic substances which are called Neurotoxins alters the normal activity of the Nervous system in Recent research has suggested that this is not the case[81] although further investigation is still ongoing.

Functional brain scans have revealed that the areas of the brain that react to sensory perceptions are active during psychosis. For example, a PET or fMRI scan of a person who claims to be hearing voices may show activation in the auditory cortex, or parts of the brain involved in the perception and understanding of speech. Positron emission tomography ( PET) is a Nuclear medicine imaging technique which produces a three-dimensional image or map of functional processes in the Functional MRI or functional Magnetic Resonance Imaging (fMRI is a type of specialized MRI scan [82]

On the other hand, there is not a clear enough psychological definition of belief to make a comparison between different people particularly valid. Belief is the psychological state in which an individual holds a Proposition or Premise to be true Brain imaging studies on delusions have typically relied on correlations of brain activation patterns with the presence of delusional beliefs. [83]

One clear finding is that persons with a tendency to have psychotic experiences seem to show increased activation in the right hemisphere of the brain. [84] This increased level of right hemisphere activation has also been found in healthy people who have high levels of paranormal beliefs[85] and in people who report mystical experiences. Paranormal is an Umbrella term used to describe unusual Phenomena or experiences that lack an obvious Scientific explanation Mysticism (from the Greek grc μυστικός mystikos, an initiate of a Mystery religion) is the pursuit of communion with identity [86] It also seems to be the case that people who are more creative are also more likely to show a similar pattern of brain activation. [87] Some researchers have been quick to point out that this in no way suggests that paranormal, mystical or creative experiences are in any way by themselves a symptom of mental illness, as it is still not clear what makes some such experiences beneficial whilst others lead to the impairment or distress of diagnosable mental pathology. However, people who have profoundly different experiences of reality or hold unusual views or opinions have traditionally held a complex role in society, with some being viewed as kooks, whilst others are lauded as prophets or visionaries. "Crank" is a Pejorative term for a person who either holds some belief which the vast majority of his contemporaries would consider false is eccentric (especially In Religion, a prophet (or prophetess) is a person who has encountered the Supernatural or the divine and serves as an intermediary

Psychosis has been traditionally linked to the neurotransmitter dopamine. See Chemical synapse for an introduction to concepts and terminology used in this article Dopamine is a Hormone and Neurotransmitter occurring in a wide variety of animals including both vertebrates and invertebrates In particular, the dopamine hypothesis of psychosis has been influential and states that psychosis results from an overactivity of dopamine function in the brain, particularly in the mesolimbic pathway. The dopamine hypothesis of schizophrenia or the dopamine hypothesis of psychosis is a model attributing symptoms of Schizophrenia (like psychoses) to a The mesolimbic pathway is one of the Neural pathways in the Brain that links the Ventral tegmentum in the Midbrain to the Nucleus accumbens The two major sources of evidence given to support this theory are that dopamine-blocking drugs (i. e. antipsychotics) tend to reduce the intensity of psychotic symptoms, and that drugs which boost dopamine activity (such as amphetamine and cocaine) can trigger psychosis in some people (see amphetamine psychosis). Antipsychotics are a group of Psychoactive drugs commonly but not exclusively used to treat Psychosis, which is typified by Schizophrenia. Cocaine ( benzoylmethyl ecgonine) is a Crystalline Tropane Alkaloid that is obtained from the leaves of the Coca plant Amphetamine psychosis is a form of Psychosis which can result from Amphetamine or Methamphetamine use [88] However, increasing evidence in recent times has pointed to a possible dysfunction of the excitory neurotransmitter glutamate, in particular, with the activity of the NMDA receptor. Glutamic acid (abbreviated as Glu or E) is one of the 20 Alpha Amino acids It is not among the human Essential amino acids Its The NMDA receptor ( NMDAR) is an Ionotropic receptor for Glutamate ( NMDA ( N -methyl D -aspartate is a name of its selective This theory is reinforced by the fact that dissociative NMDA receptor antagonists such as ketamine, PCP and dextromethorphan/detrorphan (at large overdoses) induce a psychotic state more readily than dopinergic stimulants, even at "normal" recreational doses. A dissociative is a drug which reduces (or blocks signals to the conscious mind from other parts of the brain typically but not necessarily limited to the Senses Such NMDA receptor antagonists are a class of Anesthetics that work to antagonize, or inhibit the action of the N-methyl d-aspartate receptor ( NMDAR Ketamine is a drug for use in human and veterinary medicine developed by Parke-Davis (today a part of Pfizer) in 1962 Phencyclidine (a complex clip of the chemical name phenylcyclohexylpiperidine, commonly initialised as PCP) is a Dissociative drug Dextromethorphan ( DXM or DM) is an Antitussive (cough suppressant drug found in many over-the-counter cold and Cough medicines The symptoms of dissociative intoxication are also considered to mirror the symptoms of schizophrenia more closely, including negative psychotic symptoms than amphetamine psychosis. Intoxication is the state of being affected by one or more psychoactive drugs. Dissociative induced psychosis happens on a more reliable and predictable basis than amphetamine psychosis, which usually only occurs in cases of overdose, prolonged use or with sleep deprivation, which can independently produce psychosis. Sleep deprivation is a general lack of the necessary amount of Sleep. New antipsychotic drugs which act on glutamate and its receptors are currently undergoing clinical trials. (See glutamate hypothesis of psychosis)

The connection between dopamine and psychosis is generally believed to be complex. While antipsychotic drugs immediately block dopamine receptors, they usually take a week or two to reduce the symptoms of psychosis. Moreover, newer and equally effective antipsychotic drugs actually block slightly less dopamine in the brain than older drugs whilst also affecting serotonin function, suggesting the 'dopamine hypothesis' may be oversimplified. Serotonin (ˌsɛrəˈtoʊnən ( 5-hydroxytryptamine, or 5-HT) is a Monoamine Neurotransmitter synthesized in serotonergic Neurons [89] Soyka and colleagues found no evidence of dopaminergic dysfunction in people with alcohol-induced psychosis[90] and Zoldan et al. reported moderately successful use of ondansetron, a 5-HT3 receptor antagonist, in the treatment of levodopa psychosis in Parkinson's disease patients. Ondansetron ( INN) (ɒnˈdænsɛtrɒn or Zofran is a Serotonin 5-HT3 receptor antagonist used mainly as an Antiemetic to Parkinson's disease (also known as Parkinson disease or PD) is a degenerative disorder of the Central nervous system that often impairs the sufferer's [91]

Psychiatrist David Healy has criticised pharmaceutical companies for promoting simplified biological theories of mental illness that seem to imply the primacy of pharmaceutical treatments while ignoring social and developmental factors which are known to be important influences in the aetiology of psychosis. David Healy is an Irish Psychiatrist who is currently a professor in Psychological Medicine at Cardiff University College of Medicine Wales. [92]

Some theories regard many psychotic symptoms to be a problem with the perception of ownership of internally generated thoughts and experiences. [93] For example, the experience of hearing voices may arise from internally generated speech that is mislabeled by the psychotic person as coming from an external source.

Treatment

The treatment of psychosis depends on the cause or diagnosis or diagnoses (such as schizophrenia, bipolar disorder and/ or substance intoxication). The first line treatment for many psychotic disorders is antipsychotic medication (oral or intramuscular injection), and sometimes hospitalisation is needed. A first-line treatment or first-line therapy is a Medical therapy recommended for the initial treatment of a Disease, sign or Symptom Antipsychotics are a group of Psychoactive drugs commonly but not exclusively used to treat Psychosis, which is typified by Schizophrenia. A hospital is an institution for Health care providing treatment by specialised staff and equipment and often but not always providing for There is growing evidence that cognitive behavior therapy[94] and family therapy[95] can be effective in managing psychotic symptoms. See also Cognitive Therapy Cognitive Behavioral Therapy ( CBT) is an umbrella-term for psychotherapeutic systems that deal with cognitions interpretations Family therapy, also referred to as couple and family therapy and family systems therapy, is a branch of Psychotherapy that works with families When other treatments for psychosis are ineffective, electroconvulsive therapy (ECT) (aka shock treatment) is sometimes utilized to relieve the underlying symptoms of psychosis due to depression. Electroconvulsive therapy ( ECT) also known as electroshock, is a controversial psychiatric treatment in which Seizures are electrically induced There is also increasing research suggesting that Animal-Assisted Therapy can contribute to the improvement in general well-being of people with schizophrenia. Animal-assisted therapy (AAT is a type of therapy that involves an Animal with specific characteristics becoming a fundamental part of a person's treatment [96]

Early intervention in psychosis

Early intervention in psychosis is a relatively new concept based on the observation that identifying and treating someone in the early stages of a psychosis can significantly improve their longer term outcome. [97] This approach advocates the use of an intensive multi-disciplinary approach during what is known as the critical period, where intervention is the most effective, and prevents the long term morbidity associated with chronic psychotic illness. This article is about a critical period in an organism's development

Newer research into the effectiveness of cognitive behavioural therapy during the early pre-cursory stages of psychosis (also known as the "prodrome" or "at risk mental state") suggests that such input can prevent or delay the onset of psychosis. See also Cognitive Therapy Cognitive Behavioral Therapy ( CBT) is an umbrella-term for psychotherapeutic systems that deal with cognitions interpretations However further research in this area is needed. [98]

History

The word psychosis was first used by Ernst von Feuchtersleben in 1845[99] as an alternative to insanity and mania and stems from the Greek ψύχωσις (psychosis), "a giving soul or life to, animating, quickening" and that from ψυχή (psyche), "soul" and the suffix -ωσις (-osis), in this case "abnormal condition"[100][101]. Baron Ernst Von Feuchtersleben ( April 29, 1806 &ndash September 3, 1849) was an Austrian Physician, Poet and Traditionally insanity or madness is the behaviour whereby a person flouts societal norms and may become a danger to himself and others Mania (from Greek μανία and that from μαίνομαι - mainomai, "to rage to be furious" is a severe medical condition Greek (el ελληνική γλώσσα or simply el ελληνικά — "Hellenic" is an Indo-European language, spoken today by 15-22 million people mainly The word was used to distinguish disorders which were thought to be disorders of the mind, as opposed to neurosis, which was thought to stem from a disorder of the nervous system. This article describes the term in psychology For the experimental metal band see Neurosis (band.

The division of the major psychoses into manic depressive insanity (now called bipolar disorder) and dementia praecox (now called schizophrenia) was made by Emil Kraepelin, who attempted to create a synthesis of the various mental disorders identified by 19th century psychiatrists, by grouping diseases together based on classification of common symptoms. Schizophrenia ( from the Greek roots schizein (σχίζειν "to split" and phrēn Emil Kraepelin ( February 15, 1856 – October 7, 1926) was a German Psychiatrist. Psychiatry is a medical specialty which exists to study, prevent, and treat Mental disorders in Humans Psychiatric Kraepelin used the term 'manic depressive insanity' to describe the whole spectrum of mood disorders, in a far wider sense than it is usually used today. A mood disorder is the term given for a group of diagnoses in the DSM IV TR classification system where a disturbance in the person's emotional mood is hypothesised In Kraepelin's classification this would include 'unipolar' clinical depression, as well as bipolar disorder and other mood disorders such as cyclothymia. Major depressive disorder, also known as major depression, unipolar depression, unipolar disorder, clinical depression, or simply depression Cyclothymia (pronounced /ˌsaɪkləˈθaɪmiə ˌsɪklə-/ is a Mood disorder. These are characterised by problems with mood control and the psychotic episodes appear associated with disturbances in mood, and patients will often have periods of normal functioning between psychotic episodes even without medication. Schizophrenia is characterized by psychotic episodes which appear to be unrelated to disturbances in mood, and most non-medicated patients will show signs of disturbance between psychotic episodes. Schizophrenia ( from the Greek roots schizein (σχίζειν "to split" and phrēn

During the 1960s and 1970s, psychosis was of particular interest to counterculture critics of mainstream psychiatric practice, who argued that it may simply be another way of constructing reality and is not necessarily a sign of illness. Counterculture (also " counter-culture " is a sociological term used to describe the values and norms of behavior of a Cultural group, or For example, R. D. Laing argued that psychosis is a symbolic way of expressing concerns in situations where such views may be unwelcome or uncomfortable to the recipients. Ronald David Laing ( 7 October 1927 – 23 August 1989 was a Scottish Psychiatrist who wrote extensively on Mental illness He went on to say that psychosis could be also seen as a transcendental experience with healing and spiritual aspects. Thomas Szasz focused on the social implications of labelling people as psychotic; a label he argues unjustly medicalises different views of reality so such unorthodox people can be controlled by society. Thomas Stephen Szasz (pronounced /sas/ born April 15, 1920 in Budapest, Hungary) is a Psychiatrist and Academic. Psychoanalysis has a detailed account of psychosis which differs markedly from that of psychiatry. Freud and Lacan outlined their perspective on the structure of psychosis in a number of works.

Since the 1970s, the introduction of a Recovery approach to mental health, which has been driven mainly by people who have experienced psychosis, or whatever name is used to describe their experiences, has led to a greater awareness that mental illness is not a lifelong disability, and that there is an expectation that recovery is possible, and probable with effective support. The Recovery Model is an approach to Mental disorder or Substance dependence (and/or from being labeled in those terms that emphasizes and supports each

See also

References

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Mind (formally the National Association for Mental Health) is a Mental health charity in England and Wales.

Dictionary

psychosis

-noun

  1. A severe mental disorder, sometimes with physical damage to the brain, marked by a deranged personality and a distorted view of reality.
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