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, continues to be used today when referring to certain mental disorders. Many people know that it is related to schizophrenia and other severe mental disorders.
So that, what is psychosis? In this article we are going to make a brief comment about it.
Psychosis is understood as set of mental disorders that generate in those who suffer from them an alteration in the perception of reality, losing contact with it and causing severe difficulties in the functioning of perception, thinking and behavior.
The concept emerged in the psychoanalytic current, appearing in 1841 and beginning to become popular in 1845. In fact, in this last year it would become popular and the division of mental disorders into neuroses (of neuropsychological origin, in which the subject has difficulties 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).
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 said 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 the 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 the majority of psychoses and psychotic-type experiences the subject is not aware of being suffering from an alteration: he is evidently aware of what he perceives, but generally he does not initially see it as something self-generated but rather as something that is really happening. And they are not mere imaginations: the subject really perceives something (he hears a voice, notices insects running over his body…), these perceptions simply do not correspond to real stimuli.
These alterations are usually linked to suffering from a mental disorder, although They can also arise from suffering a brain injury, an organic pathology (a tumor or infection for example) or substance consumption (whether drugs or medications). But sometimes we can also present some type of psychotic symptom without having to suffer from a specific problem or be intoxicated: there are some hallucinations that arise during 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 attempted to be explained in multiple ways and by different theoretical currents. Today The causes of psychoses remain largely unknown and the explanations proposed 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 psychotic disorders are considered to be the product 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 must be taken into account that different frameworks and schools 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, requiring 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-feats (defeats, failures and situations that make that the subject feels ashamed and self-deprecating), which end up causing the subject to deceive themselves to protect themselves and little by little 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 about whether psychosis itself constitutes a psychological or psychiatric disorder 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 that have been grouped under the same name due to a superficial similarity.
Some psychotic disorders
Psychosis is a generic term that refers to the general functioning of this type of disorder. But actually There are a large number of different psychopathologies that are included in this category Likewise, 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. Below are some of the main psychotic disorders.
1. Schizophrenia
The best known and prototypical of psychotic disorders, schizophrenia is a disorder in which hallucinations, delusions and language alterations usually appear Disorganized behavior, catatonia, or negative symptoms such as impoverishment of thinking and judgment may also appear. It generally occurs in the form of outbreaks and generates a great deal of difficulty for those who suffer from it. The symptoms last at least six months and can end up causing cognitive impairment.
2. Chronic delusional disorder
Another of the major mental disorders of a psychotic type, chronic delusional disorder is characterized by the existence of alterations in the content of thought, there are strange beliefs that do not fit reality 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 can be more or less systematized, and the subject often considers that the evidence supports his beliefs and ignores those elements that contradict them.
It is a psychotic-type disorder that shares most of its symptoms with schizophrenia, except for the fact that the duration of your 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 along with mood disorders such as depressive or manic episodes psychotic symptoms existing 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 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 nerve or brain involvement Dementia, 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-type experiences, both at the time of consuming them and during 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 a month.
9. Occasional symptom in other disorders
It must be taken into account that in addition to the psychotic disorders themselves, many Other psychopathologies may present with some psychotic elements This is what happens with depression or bipolar disorder, in which hallucinations and psychotic phenomena may occasionally appear.
