Psychosis - Psychiatric Disorders

Psychiatric Disorders

From a diagnostic standpoint, organic disorders were those held to be caused by physical illness affecting the brain (that is, psychiatric disorders secondary to other conditions), while functional disorders were considered to be disorders of the functioning of the mind in the absence of physical disorders (that is, primary psychological or psychiatric disorders). The materialistic view of the mind–body problem holds that mental disorders arise from physical processes; in this view, the distinction between brain and mind, and therefore between organic and functional disease, is an artificial one. Subtle physical abnormalities have been found in illnesses traditionally considered functional, such as schizophrenia. The DSM-IV-TR avoids the functional/organic distinction, and instead lists traditional psychotic illnesses, psychosis due to general medical conditions, and substance-induced psychosis.

Primary psychiatric causes of psychosis include the following:

• schizophrenia and schizophreniform disorder
• affective (mood) disorders, including severe depression, and severe depression or mania in bipolar disorder (manic depression). 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.
• schizoaffective disorder, involving symptoms of both schizophrenia and mood disorders
• brief psychotic disorder, or acute/transient psychotic disorder
• delusional disorder (persistent delusional disorder)
• chronic hallucinatory psychosis

Psychotic symptoms may also be seen in

• schizotypal disorder
• certain personality disorders at times of stress (including paranoid personality disorder, schizoid personality disorder, and borderline personality disorder)
• major depressive disorder in its severe form although it is possible and more likely to have severe depression without psychosis
• bipolar disorder in severe mania and/or severe depression although it is possible to have severe mania and/or severe depression without psychosis as well, in fact that is more commonly the case
• post-traumatic stress disorder
• induced delusional disorder
• Sometimes in obsessive-compulsive disorder

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. 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.

B12 deficiency can also cause characteristics of psychosis and mania. Most hospitals and mental facilities do not check for B12 deficiencies.