Psychosis

Psychosis Overview

• Definition: Psychosis is a mental condition leading to difficulties in determining reality.
• Signs and Symptoms: Include delusions, hallucinations, incoherent speech, inappropriate behavior, sleep problems, and social withdrawal.
• Causes: Mental illnesses like schizophrenia, bipolar disorder, trauma, sleep deprivation, certain medications, and substance abuse.
• Epidemiology: Around 3% of people in the US experience psychosis in their lifetime.
• History: Documented since ancient times by Hippocrates and in the Egyptian Ebers Papyrus.
• Treatment: Involves antipsychotic medication, psychotherapy, and social support.
• Postpartum Psychosis: Specific type occurring after childbirth, linked to bipolar disorder, with an increased risk of suicide or infanticide.

Symptoms and Manifestations

• Hallucinations: Sensory perceptions without external stimuli, involving any sense and taking various forms.
• Delusions: Fixed false beliefs despite evidence, prevalent in schizophrenia and bipolar disorder.
• Disorganization of Speech/Thought or Behavior: Includes disorganized speech, motor behavior, and catatonia types.
• Negative Symptoms: Reduced emotional expression, motivation, and spontaneous speech, with anhedonia and altered behavioral inhibition system functioning.
• Psychosis in Adolescents: Rare but can lead to hallucinations, delusions, cognitive deficits, and comorbidities, making diagnosis challenging.

Causes and Risk Factors

• Psychiatric Disorders: Serious conditions like schizophrenia and bipolar disorder.
• Temporary Psychosis: Induced by medications or substance use.
• Normal States: Brief hallucinations in healthy individuals due to falling asleep, severe sleep deprivation, or extreme stress.
• Psychoactive Drugs: Various substances can cause or exacerbate psychotic states, with cannabis, methamphetamine, and alcohol having specific effects.
• Neurobiology: Involving dopamine, NMDA receptor dysfunction, and abnormal brain activation in hallucinations and delusions.

Effects of Specific Substances

• Alcohol: About 3% of people with alcoholism experience psychosis, leading to chronic substance-induced psychotic disorders.
• Cannabis: Associated with an increased risk of psychotic disorders, with THC and CBD having opposite effects on psychosis.
• Methamphetamine: Induces psychosis in heavy users, with genetic vulnerability and long-lasting effects on brain neurochemistry.
• Psychoactive Drugs: Caffeine may worsen symptoms in schizophrenia, while cannabis and illicit drugs are linked to psychosis, especially in adolescents.

Neurobiology and Culture

• Dopamine Hypothesis: Suggests antipsychotics reduce symptoms by affecting dopamine receptors, with a complex relationship between dopamine and psychosis.
• Neurobiology: Involving NMDA receptor dysfunction, hierarchical Bayesian neurocomputational models, and reduced GAD67 expression in psychotic disorders.
• Culture: Cross-cultural studies show varying experiences of psychosis, with different interpretations and experiences of hallucinations in different regions.

Psychosis Data Sources