Psychotic disorders 

are a group of serious illnesses that affect the mind. They make it hard for
someone to think clearly, make good judgments, respond emotionally, communicate effectively,
understand reality, and behave appropriately.

During a psychotic episode, an individual may experience hallucinations and/or delusions.

They may see or hear things that do not exist.

This can be incredibly frightening for the individual and, sometimes, the symptoms can cause
them to lash out and hurt themselves or others.

Psychosis is classically associated with schizophrenia spectrum disorders, and, although there

are other symptoms, one of the defining criteria for schizophrenia is the presence of
psychosis.

Symptoms of psychosis

 Hallucinations – hearing, seeing, or feeling things that do not exist

 Delusions – false beliefs, especially based on fear or suspicion of things that are not
real

 Disorganization – in thought, speech, or behavior

 Disordered thinking – jumping between unrelated topics, making strange

connections between thoughts

 Difficulty concentrating

Causes of psychosis

The exact causes of psychosis are not well understood but might involve:

 Genetics – research shows that schizophrenia and bipolar disorder may share

a common genetic cause.

 Brain changes – alterations in brain structure and changes in certain chemicals are
found in people who have psychosis. Brain scans have revealed reduced gray
 matter in the brains of some individuals who have a history of psychosis, which may
explain effects on thought processing.

 Hormones/sleep – postpartum psychosis occurs very soon after giving birth

(normally within 2 weeks). The exact causes are not known, but some researchers
believe it might be due to changes in hormone levels and disrupted sleep patterns.

Diagnosis of psychosis

In this section, we will discuss the available tests and methods for diagnosing psychosis.

Early diagnosis

Early diagnosis of psychosis improves long-term outcomes. This is not always achieved,
however. The milder forms of psychosis that can lead to schizophrenia are left untreated for
an average of 2 years, and even full psychosis can take a number of years before it receives
the attention of medical professionals.

To increase the chances of early detection, guidance for healthcare systems drawn up by

psychiatrists recommend that the “possibility of a psychotic disorder should be carefully
considered” in a young person who is:

 Becoming more socially withdrawn

 Performing worse for a sustained period at school or work, or

 Becoming more distressed or agitated yet unable to explain why

There is no biological test for psychosis itself, and if laboratory tests are done, it is to rule out
other medical problems that might provide an alternative explanation.
 NEUROSIS

Neurosis refers to a class of functional mental disorder involving distress but not delusions or
hallucinations, where behavior is not outside socially acceptable norms. It is also known as
psychoneurosis or neurotic disorder.

Categories
The neurotic disorders are distinct from psychotic disorders in that the individual with
neurotic symptoms has a firm grip on reality, and the psychotic patient does not. There are
several major traditional categories of psychological neuroses. These include:

 Anxiety neurosis. Mental illness defined by excessive anxiety and worry, sometimes

involving panic attacks and manifesting itself in physical symptoms such as tremor,
chest pain, sweating, and nausea.
 Depressive neurosis. A mental illness characterized by a profound feeling of sadness
or despair and a lack of interest in things that were once pleasurable.
 Obsessive-compulsive neurosis. The persistent and distressing recurrence of intrusive
thoughts or images (obsessions) and repetitive behaviours or mental acts
(compulsions).
 Post-traumatic stress disorder (also called war or combat neurosis). Severe stress and
functional disability caused by witnessing a traumatic event such as war combat or
any other event that involved death or serious injury.

Diagnosis
Patients with symptoms of mental illness should undergo a thorough physical examination
and detailed patient history to rule out organic causes (such as brain tumour or head injury).If
a neurotic disorder is suspected, a psychologist or psychiatrist will usually conduct an
interview with the patient and administer clinical assessments (also called scales, inventories,
or tests), to evaluate mental status.

Treatment
Neurosis should be treated by a counsellor, therapist, psychologist, psychiatrist, or other
mental healthcare professional. Treatment for a neurotic disorder depends on the presenting
symptoms and the level of discomfort they are causing the patient. Modes of treatment are
similar to that of other mental disorders, and can include psychotherapy, cognitive-
behavioural therapy, creative therapies (e.g., art or music therapy), psychoactive drugs, and
relaxation exercises.