The symptoms of psychosis, such as those that occur in schizophrenia , are particularly striking within the wide range of mental disorders: hallucinations or delusions fit perfectly with many people’s idea of psychopathology.
The terms “psychosis” and “schizophrenia” are often used interchangeably. However, there are clear conceptual differences between them ; in this article we will see what they are and clarify what their relationship is.
What is psychosis?
A series of symptoms related to the loss of contact with reality is known as “psychosis”. It is often associated with alterations in thinking and behaviour, including verbal behaviour, which cause alterations in many areas of functioning.
The term was first used in 1841 by the German psychiatrist Karl Friedrich Canstatt. It comes from Latin and can be translated as “soul alteration” or “mind alteration”. It initially included schizophrenia and bipolar disorder and was used in opposition to the concept of “neurosis” , which is still common today.
The experiences included in the concept of psychosis are multiple and varied. Hallucinations, delusions and catatonia (a state of psychogenic immobility) are three of the most characteristic psychotic manifestations, but they do not always occur in pathological contexts; for example, hypnagogic hallucinations, which sometimes appear just before we fall asleep, are formally equivalent to psychosis.
Psychotic symptoms can have very different causes . As in schizophrenia, bipolar disorder or dementia, they are usually the result of the combination of psychosocial stress with cerebral disorders, or with the excessive use of certain substances and drugs, including alcohol and amphetamines.
Psychotic disorders, on the other hand, include schizophrenia, schizotypal personality disorder, schizoaffective disorder, delusional disorder, schizophreniform disorder, brief psychotic disorder, catatonia, and psychoses induced by disease and substance use.
Definition of Schizophrenia
Schizophrenia is a disorder that is included in the group of psychotic disorders , being the most representative and known of these. Its cardinal symptoms are of a psychotic type, such as disorganization of thought or the presence of delusions and hallucinations.
It is a disorder that frequently generates social maladjustment and favors the appearance of depression, anxiety and substance abuse . In many cases it occurs chronically and is managed by means of very powerful antipsychotic drugs, frequently requiring hospitalisation.
The symptoms of schizophrenia are divided into positive and negative . The positive symptoms are related to the alteration of mental functions, such as hallucinations, while the negative ones are emotional, motivational or social deficits, among others.
The DSM-IV manual divides schizophrenia into five types: paranoid, disorganized, catatonic, undifferentiated and residual . This classification is made according to the predominant symptoms and the course of the disorder. The DSM-5 eliminated the distinction between subtypes of schizophrenia.
The diagnosis of schizophrenia requires that delusions, hallucinations, disorganized speech, catatonia, or negative symptoms have been present continuously for at least 6 months. In addition, these symptoms must cause personal, social or work difficulties and cannot be directly due to a disease or the consumption of drugs or medication .
Differences between psychosis and schizophrenia
In summary, we can say that “psychosis” and “schizophrenia” are two closely related concepts, but schizophrenia is a mental disorder with specific diagnostic criteria, while psychosis is a group of symptoms that can occur because of schizophrenia or for other reasons.
Below you will find 5 keys that will help you differentiate psychosis and schizophrenia .
1. One includes the other
Schizophrenia is a disorder that causes multiple symptoms, including but not limited to psychotic symptoms: for example, anxiety and depression are also very common in the context of schizophrenia.
Psychosis, on the other hand, encompasses schizophrenia if we understand the term “psychosis” as equivalent to “psychotic disorder. This usually happens when we refer to this group of disorders as “the psychoses”.
2. Psychosis does not always involve schizophrenia
Psychotic experiences are relatively frequent in certain settings, such as the use of hallucinogenic substances or brain damage due to dementia. Thus, it is not necessary to meet the criteria of schizophrenia in order to be able to speak of the existence of a psychosis, especially if it is a brief episode.
3. The presence of psychopathology
When they occur as a result of schizophrenia or other more or less similar disorders, such as psychotic depression or schizoaffective disorder, psychotic symptoms are considered a key indicator of psychopathology. In affective disorders or dementia, psychotic symptoms are associated with an increase in severity or progression of the disorder.
However, psychotic symptoms do not always imply a greater severity : people diagnosed with paranoid schizophrenia, which is characterized by hallucinations and delusions, have a better prognosis than those in which negative symptoms predominate.
4. Duration of symptoms
The duration of psychotic manifestations varies greatly, from drug-induced episodes of a few seconds or minutes to schizophrenia, which requires that the symptoms be maintained for at least 6 months . In between is brief psychotic disorder, which has a maximum duration of one month.
5. Psychosis has multiple causes
Although the cerebral alterations characteristic of schizophrenia can provoke psychotic experiences, these too can be due to other psychological and biological causes . These include intense stress and fatigue, depression, brain damage and the use of certain substances.