Psychosis

There are a number of psychological disorders that come under the general title of the psychoses.  They all differ in symptoms, but all are joined by the fact that the sufferer is in someway not experiencing reality.

Types of psychosis include:

• Schizophrenia
• Schizoaffective disorder
• Manic-depression (bipolar disorder)
• Mania
• Delusional (paranoid) disorders
• Psychotic depression

There is disagreement over the psychiatric classification of the various psychoses.  Many experts argue that it is more helpful to treat people according to the specific symptoms that they have (e.g. hearing voices in their head) rather than putting them under a label such as "schizophrenic", which can cover widely different people, with widely different problems.

Causes and Development

Psychosis is not fully understood, and some theories as to its cause include: it is hereditary; there is a 'wiring problem' in the brain; there is a chemical imbalance in the brain or body; it results from extreme stress or anxiety; it is a psychological defense mechanism – or a combination of these.

Known causes include: Illegal drug use (e.g. cannabis, LSD); infections (e.g. meningitis); brain tumors; epilepsy; head injuries.

Signs and Symptoms

Psychosis can take many forms, such as:

• Sensing things that aren't really there (hallucinations)
• Having beliefs that aren't based on reality (delusions)
• Problems in thinking clearly (e.g. thought insertion, withdrawal, block, broadcasting)
• Not realizing that there is anything wrong with oneself (lack of insight)

People suffering with a long-term psychosis often have problems looking after themselves, and getting on well with other people.

Treatment and Prevention

Psychosis has been shown to respond well to treatments such as antipsychotic medication and, more recently, Cognitive-Behavioral Therapy has been promoted.  Family and group therapies are often suggested as working well in certain cases.  Despite providing quite useful ways of thinking about psychosis, traditional psychodynamic therapies are generally not thought to work well, and some people even consider them potentially harmful.

Social skills training, occupational therapy and supported employment schemes have been shown to help some long-term sufferers, without necessarily treating the underlying psychosis.

Prognosis

It is thought that detecting psychosis at an early (prodromal) stage provides better prospects for treating it.  Some people who experience a psychosis may only experience it once throughout their whole life (this is called a 'single episode'), other people may have problems with it for the rest of their lives.