Psychosis

psychosis, plural psychoses, any of several major mental illnesses that can cause delusions, hallucinations, serious defects in judgment and other cognitive processes, and the inability to evaluate reality objectively. A brief treatment of psychosis follows. For full treatment, see mental disorder.

The term psychosis is derived from the Greek psyche, meaning “soul,” “mind,” or “breath.” The ancient Greeks believed that the breath was the animating force of life and that when the breath left the body, as happened in death, the soul left the body. Because words that contain the root psyche (e.g., psychiatrist, psychiatry, etc.) are associated with the essence of life (usually related to the soul or human spirit) psychosis has come to mean that a person has lost the essence of life—that he or she has developed a private view of the world or a private reality not shared by others.

It is difficult to clearly demarcate psychoses from the class of less-severe mental disorders known as psychoneuroses (commonly called neuroses) because a neurosis may be so severe, disabling, or disorganizing in its effects that it actually constitutes a psychosis. However, in general, patients suffering from the recognized psychotic illnesses exhibit a disturbed sense of reality and a disorganization of personality that sets them apart from neurotics. Such patients also frequently believe that nothing is wrong with them, despite the palpable evidence to the contrary as evinced by their confused or bizarre behaviour. Psychotics may require hospitalization because they cannot take care of themselves or because they may constitute a danger to themselves or to others.

The major defining symptoms of psychosis are hallucinations and delusions. A hallucination is a sensory perception experienced only by the affected person; it is not shared by others. For example, persons experiencing hallucinations may hear a voice telling them to commit suicide or to cut themselves, but no one else can hear this voice. A delusion is a belief not credible to others. The belief expressed by the affected person usually has little basis in the person’s past. For example, a casually religious person who is experiencing a psychosis may suddenly begin to tell other people that he is Christ, Muhammad, or Buddha or that he has been selected by God for some special task. There is no evidence that would make anyone else share this belief. A person can experience both hallucinations and delusions or just one or the other. Hallucinations and delusions are most often caused by a disturbance or change in brain function.

Psychoses may be divided into two categories: organic and functional. Organic psychoses are characterized by abnormal brain function that is caused by a known physical abnormality, which in most cases is some organic disease of the brain. However, altered brain function that precipitates hallucinations and delusions is more often associated with specific psychiatric disorders, which are categorized as functional psychoses.