'Psychosis' is a generic
psychiatric term for a
mental state often described as involving a "loss of contact with
reality". ''Stedman's Medical Dictionary'' defines psychosis as "a severe mental disorder, with or without organic damage, characterized by derangement of personality and loss of contact with reality and causing deterioration of normal social functioning."
[1]
People experiencing a psychotic episode may report
hallucinations or
delusional beliefs (e.g., grandiose or
paranoid delusions), and may exhibit changes and
disorganized thinking. This is often accompanied by
lack of insight into the unusual or bizarre nature of their behaviour, as well as difficulty with social interaction and impairment in carrying out the activities of daily living.
A wide variety of nervous system stressors, both organic and functional, can cause a psychotic reaction. This has led to the belief that psychosis is the 'fever' of mental illness—a serious but nonspecific indicator.
[{{cite journal | last = DeLage | first = J. | year = 1955 | month = February | title = [Moderate psychosis caused by mumps in a child of nine years.] | journal = Laval Médical | volume = 20 | issue = 2 | pages = 175-183 | id = ]
However, most people have unusual and reality-distorting experiences at some point in their lives, without being impaired or even distressed by these experiences. For example, many people have experienced hallucinations, and some have even found inspiration or religious revelation in them.[2] As a result, it has been argued that psychosis is not fundamentally separate from normal consciousness, but rather, is on a continuum with normal consciousness.
In pop culture, the term "psychotic" is often used incorrectly to refer to psychopathy.
History
The word ''psychosis'' was first used by Ernst von Feuchtersleben in 1845[3] as an alternative to insanity and mania and stems from the Greek ''psyche'' (mind) and ''-osis'' (diseased or abnormal condition).[4] The word was used to distinguish disorders which were thought to be disorders of the mind, as opposed to neurosis, which was thought to stem from a disorder of the nervous system.
The division of the major psychoses into manic depressive insanity (now called bipolar disorder) and dementia praecox (now called schizophrenia) was made by Emil Kraepelin, who attempted to create a synthesis of the various mental disorders identified by 19th century psychiatrists, by grouping diseases together based on classification of common symptoms. Kraepelin used the term 'manic depressive insanity' to describe the whole spectrum of mood disorders, in a far wider sense than it is usually used today. In Kraepelin's classification this would include 'unipolar' clinical depression, as well as bipolar disorder and other mood disorders such as cyclothymia. These are characterised by problems with mood control and the psychotic episodes appear associated with disturbances in mood, and patients will often have periods of normal functioning between psychotic episodes even without medication. Schizophrenia is characterized by psychotic episodes which appear to be unrelated to disturbances in mood, and most non-medicated patients will show signs of disturbance between psychotic episodes.
During the 1960s and 1970s, psychosis was of particular interest to counterculture critics of mainstream psychiatric practice, who argued that it may simply be another way of constructing reality and is not necessarily a sign of illness. For example, R. D. Laing argued that psychosis is a symbolic way of expressing concerns in situations where such views may be unwelcome or uncomfortable to the recipients. He went on to say that psychosis could be also seen as a transcendental experience with healing and spiritual aspects. Thomas Szasz focused on the social implications of labelling people as psychotic; a label he argues unjustly medicalises different views of reality so such unorthodox people can be controlled by society. Psychoanalysis has a detailed account of psychosis which differs markedly from Psychiatry. Freud and Lacan outlined their perspective on the structure of psychosis in a number of works Lacan and Freud on the structure of psychosis :
In medical practice today, a descriptive approach to psychosis (and to all mental illness) is used, based on behavioral and clinical observations. This approach is adopted in the standard guide to psychiatric diagnoses employed in the United States, the Diagnostic and Statistical Manual of Mental Disorders (DSM). Since the DSM provides a widely-used standard of reference, the description presented here will largely reflect that point of view.
Classification
According to the DSM, psychosis can be a symptom of mental illness, but it is not a mental illness in its own right. For example, people with schizophrenia often experience psychosis, but so can people with bipolar disorder (manic depression), unipolar depression, delirium, or drug withdrawal.[5][ ] People diagnosed with these conditions can also have long periods ''without'' psychosis. Conversely, psychosis can occur in people who do not have chronic mental illness (e.g. due to an adverse drug reaction or extreme stress).[{{cite journal | last = Jauch | first = D. A. | coauthors = William T. Carpenter, Jr. | year = 1988 | month = February | title = Reactive psychosis. I. Does the pre-DSM-III concept define a third psychosis? | journal = Journal of Nervous and Mental Disease | volume = 176 | issue = 2 | pages = 72-81 | id = ]
Psychosis should be distinguished from insanity, which is a legal term denoting that a person is not criminally responsible for his or her actions.[6]
Psychosis should be distinguished from psychopathy, a personality disorder associated with violence, lack of empathy and socially manipulative behavior.[Hare, R. D. Psychopathy and Antisocial Personality Disorder: A Case of Diagnostic Confusion, Psychiatric Times, February 1996, XIII, Issue 2 Accessed June 26, 2006] Despite both being colloquially abbreviated "psycho", psychosis bears little similarity to the core features of psychopathy, particularly with regard to violence, which rarely occurs in psychosis,
Psychosis should also be distinguished from delirium: a psychotic individual may be able to perform actions that require a high level of intellectual effort in clear consciousness, whereas a delirious individual will have impaired memory and cognitive function.
Causes
Causes of mental illness are customarily distinguished as "organic" or "functional". Organic causes are those for which a medical, pathophysiological basis can be found. Functional causes are "the rest", the psychological causes properly speaking, e.g. anxiety, depression, etc.
"Functional" causes
Functional causes of psychosis include the following:
★ schizophrenia
★ bipolar disorder (manic depression)
★ severe clinical depression
★ severe psychosocial stress
★ sleep deprivation
A psychotic episode can be significantly affected by mood. For example, 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.
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. ]
Sleep deprivation has been linked to psychosis.[{{cite journal | last = Chan-Ob | first = T. | coauthors = V. Boonyanaruthee | year = 1999 | month = September | title = Meditation in association with psychosis | journal = Journal of the Medical Association of Thailand | volume = 82 | issue = 9 | pages = 925-930 | id = ][{{cite journal | last = Devillieres | first = P. | coauthors = M. Opitz, P. Clervoy, and J. Stephany | year = 1996 | month = May-June | title = [Delusion and sleep deprivation] | journal = L'Encéphale | volume = 22 | issue = 3 | pages = 229-231 | id = ] However, this is not a risk for most people, who merely experience hypnagogic or hypnopompic hallucinations, i.e. unusual sensory experiences or thoughts that appear during waking or drifting off to sleep. These are normal sleep phenomena and are not considered signs of psychosis.
"Organic" causes
Psychosis arising from "organic" (non-psychological) conditions is sometimes known as 'secondary psychosis'. It can be associated with the following pathologies:
★ neurological disorders, including:
★
★ brain tumour
★
★ dementia with Lewy bodies
★
★ multiple sclerosis[ ]
★
★ sarcoidosis
★
★ Lyme Disease[7][8][9]
★
★ syphilis [10][11]
★
★ Alzheimer's Disease[12]
★
★ Parkinson's Disease[13]
★ electrolyte disorders such as:
★
★ hypocalcemia
★
★ hypernatremia[{{cite journal | last = Jana | first = D. K. | coauthors = L. Romano-Jana | year = 1973 | month = October | title = Hypernatremic psychosis in the elderly: case reports | journal = Journal of the American Geriatrics Society | volume = 21 | issue = 10 | pages = 473-477 | id = ]
★
★ hyponatremia[{{cite journal | last = Haensch | first = C. A. | coauthors = G. Hennen and J. Jorg | year = 1996 | month = April | title = [Reversible exogenous psychosis in thiazide-induced hyponatremia of 97 mmol/l] | journal = Der Nervenarzt | volume = 67 | issue = 4 | pages = 319-322 | id = ]
★
★ hypokalemia[{{cite journal | last = Hafez | first = H. | coauthors = J. S. Strauss, M. D. Aronson, and C. Holt | year = 1984 | month = June | title = Hypokalemia-induced psychosis in a chronic schizophrenic patient | journal = Journal of Clinical Psychiatry | volume = 45 | issue = 6 | pages = 277-279 | id = ]
★
★ hypomagnesemia[ Hypomagnesemia ]
★
★ hypermagnesemia
★
★ hypercalcemia[{{cite journal | last = Rosenthal | first = M. | coauthors = I. Gil and B. Habot | year = 1997 | title = Primary hyperparathyroidism: neuropsychiatric manifestations and case report | journal = Israel Journal of Psychiatry and Related Sciences | volume = 34 | issue = 2 | pages = 122-125 | id = ]
★
★ hypophosphatemia[{{cite journal | last = Nanji | first = A. A. | year = 1984 | month = November | title = The psychiatric aspect of hypophosphatemia | journal = Canadian Journal of Psychiatry | volume = 29 | issue = 7 | pages = 599-600 | id = ]
★ hypoglycemia[ ]
★ lupus
★ AIDS[ Neuropsychopharmacology: The Fifth Generation of Progress, , Dwight L., Evans, Lippincott Williams & Wilkins, , ISBN 0-7817-2837-1 ]
★ leprosy
★ malaria[{{cite journal | last = Tilluckdharry | first = C. C. | coauthors = D. D. Chaddee, R. Doon, and J. Nehall | year = 1996 | month = March | title = A case of vivax malaria presenting with psychosis | journal = West Indian Medical Journal | volume = 45 | issue = 1 | pages = 39-40 | id = ]
★ Adult-onset vanishing white matter leukoencephalopathy[14]
★ Late-onset metachromatic leukodystrophy[15][16][17]
Psychosis can even be caused by apparently innocuous ailments such as flu[{{cite journal | last = Steinberg | first = D. | coauthors = S. R. Hirsch, S. D. Marston, K. Reynolds, and R. N. Sutton | year = 1972 | month = May | title = Influenza infection causing manic psychosis | journal = British Journal of Psychiatry | volume = 120 | issue = 558 | pages = 531-535 | id = ][{{cite journal | last = Maurizi | first = C. P. | year = 1985 | month = February | title = Influenza and mania: a possible connection with the locus ceruleus | journal = Southern Medical Journal | volume = 78 | issue = 2 | pages = 207-209 | id = ] or mumps.[{{cite journal | last = Keddie | first = K. M. | year = 1965 | month = August | title = Toxic psychosis following mumps | journal = British Journal of Psychiatry | volume = 111 | pages = 691-696 | id = ]
Psychoactive drugs
Psychotic states may occur with Psychoactive drug intoxication or withdrawal. Drugs whose use, abuse or withdrawal are implicated include:
★ alcohol[ Alcohol-Related Psychosis ][{{cite journal | last = Soyka | first = Michael | year = 1990 | month = March | title = Psychopathological characteristics in alcohol hallucinosis and paranoid schizophrenia. | journal = Acta Psychiatrica Scandanavica | volume = 81 | issue = 3 | pages = 255-9 | id = ][ Delirium Tremens ]
★ OTC drugs, such as:
★
★ Dextromethorphan
★
★ Certain antihistamines at high doses.[{{cite journal | last = Lang | first = K. | coauthors = H. Sigusch, and S. Muller | date = December 8, 1995 | title = [An anticholinergic syndrome with hallucinatory psychosis after diphenhydramine poisoning] | journal = Deutsche medizinische Wochenschrift | volume = 120 | issue = 49 | pages = 1695-1698 | id = ][{{cite journal | last = Schreiber | first = W. | coauthors = A. M. Pauls and J. C. Kreig | date = February 5, 1988 | title = [Toxic psychosis as an acute manifestation of diphenhydramine poisoning] | journal = Deutsche medizinische Wochenschrift | volume = 113 | issue = 5 | pages = 180-183 | id = ]
★
★ Cold Medications[18] (ie. containing PPA, or phenylpropanolamine)
★ prescription drugs, such as:
★
★ barbiturates[{{cite journal | last = Sarrecchia | first = C. | coauthors = P. Sordillo, G. Conte, and G. Rocchi | year = 1998 | month = October-December | title = [Barbiturate withdrawal syndrome: a case associated with the abuse of a headache medication] | journal = Annali Italiani di Medicina Interna | volume = 13 | issue = 4 | pages = 237-239 | id = ]
★
★ benzodiazepines[{{cite journal | last = White | first = M. C. | coauthors = J. J. Silverman, and J. W. Harbison | year = 1982 | month = February | title = Psychosis associated with clonazepam therapy for blepharospasm | journal = Journal of Nervous and Mental Disease | volume = 170 | issue = 2 | pages = 117-9 | id = ][{{cite journal | last = Jaffe | first = R. | coauthors = E. Gibson | year = 1986 | month = June | title = Clonazepam withdrawal psychosis | journal = Journal of Clinical Psychopharmacology | volume = 6 | issue = 3 | pages = 193 | id = ]
★
★ Anticholinergic drugs
★
★
★ atropine[{{cite journal | last = Varghese | first = S. | coauthors = N. Vettath, K. Iyer, J. M. Puliyel, and M. M. Puliyel | year = 1990 | month = June | title = Ocular atropine induced psychosis--is there a direct access route to the brain? | journal = Journal of the Association of Physicians of India | volume = 38 | issue = 6 | pages = 444-445 | id = ]
★
★
★ scopolamine
★
★
★ Jimson weed
★
★ antidepressants
★
★ antiepileptics[19]
★
★ medications (usually cold medications) that contain phenylpropanolamine or PPA [20]
★ "street" drugs, such as:
★
★ cocaine[{{cite journal | last = Brady | first = K. T. | coauthors = R. B. Lydiard, R. Malcolm, and J. C. Ballenger | year = 1991 | month = December | title = Cocaine-induced psychosis. | journal = Journal of Clinical Psychiatry | volume = 52 | issue = 12 | pages = 509-512 | id = ]
★
★ amphetamines
★
★ hallucinogens such as
★
★
★ LSD
★
★
★ psilocybin
★
★
★ mescaline
★
★
★ MDMA (ecstasy)
★
★
★ PCP
Intoxication with drugs that have general depressant effects on the central nervous system (especially alcohol and barbiturates) tend not to cause psychosis during use, and can actually decrease or lessen the impact of symptoms in some people. However, ''withdrawal'' from barbiturates and alcohol can be particularly dangerous, leading to psychosis or delirium and other, potentially lethal, withdrawal effects.
Some studies indicate that cannabis use may lower the threshold for psychosis, and thus help to trigger full-blown psychosis in some people.[ Editorial: The link between cannabis use and psychosis: furthering the debate., , L, Degenhardt, Psychological Medicine, ] Early studies have been criticized for failing to consider other drugs (such as LSD) that the participants may have used before or during the study, as well as other factors such as pre-existing ("comorbid") mental illness. However, more recent studies with better controls have still found a small increase in risk for psychosis in cannabis users .
It is not clear whether this is a causal link, and it is possible that cannabis use only increases the chance of psychosis in people already predisposed to it; or that people with developing psychosis use cannabis to provide temporary relief of their mental discomfort. The fact that cannabis use has increased over the past few decades, whereas the rate of psychosis has not, suggests that a direct causal link is unlikely for all users.[21]
Signs and symptoms
Hallucinations
Hallucinations are defined as sensory perception in the absence of external stimuli. They are different from illusions, or perceptual distortions, which are the misperception of external stimuli.[22] Hallucinations may occur in any of the five senses and take on almost any form, which may include simple sensations (such as lights, colors, tastes, and smells) to more meaningful experiences such as seeing and interacting with fully formed animals and people, hearing voices and complex tactile sensations.
Auditory hallucinations, particularly the experience of hearing voices, are a common and often prominent feature of psychosis. Hallucinated voices may talk about, or to the person, and may involve several speakers with distinct personas. Auditory hallucinations tend to be particularly distressing when they are derogatory, commanding or preoccupying. However, the experience of hearing voices need not always be a negative one. Research has shown that the majority of people who hear voices are not in need of psychiatric help.[23] The Hearing Voices Movement has subsequently been created to support voice hearers, regardless of whether they are considered to have a mental illness or not.
Delusions and paranoia
Psychosis may involve delusional or paranoid beliefs. Karl Jaspers classified psychotic delusions into ''primary'' and ''secondary'' types. Primary delusions are defined as arising out of the blue and not being comprehensible in terms of normal mental processes, whereas secondary delusions may be understood as being influenced by the person's background or current situation (e.g., ethnic or sexual discrimination, religious beliefs, superstitious belief).[ Allgemeine Psychopathologie (General Psychopathology), , Karl, Jaspers, Johns Hopkins University Press, , ISBN 0-8018-5775-9 ]
Thought disorder
Formal thought disorder describes an underlying disturbance to conscious thought and is classified largely by its effects on speech and writing. Affected persons may show pressure of speech (speaking incessantly and quickly), derailment or flight of ideas (switching topic mid-sentence or inappropriately), thought blocking, and rhyming or punning.
Lack of insight
One important and puzzling feature of psychosis is usually an accompanying lack of insight into the unusual, strange, or bizarre nature of the person's experience or behaviour.
It was previously believed that lack of insight was related to general cognitive dysfunction[{{cite journal | last = Lysaker | first = Paul H. | coauthors = Morris D. Bell | year = 1994 | month = November | title = Insight and cognitive impairment in schizophrenia. Performance on repeated administrations of the Wisconsin Card Sorting Test | journal = Journal of Nervous and Mental Disease | volume = 182 | issue = 11 | pages = 656-660 | id = ] or to avoidant coping style.
In some cases, particularly with auditory and visual hallucinations, the person experiencing the hallucinations has good insight, which may make the psychotic experience even more terrifying because the person realizes that he or she should not be hearing voices, but is.
Pathophysiology
Brain imaging studies of psychosis, investigating both changes in brain structure and changes in brain function of people undergoing psychotic episodes, have shown mixed results.
The first brain image of a person with psychosis was completed as far back as 1935 using a technique called pneumoencephalography[24] (a painful and now obsolete procedure where cerebrospinal fluid is drained from around the brain and replaced with air to allow the structure of the brain to show up more clearly on an X-ray picture).
More recently, a 2003 study investigating structural changes in the brains of people with psychosis showed there was significant grey matter reduction in the cortex of people before and after they became psychotic.[25] Findings such as these have led to debate about whether psychosis is itself neurotoxic and whether potentially damaging changes to the brain are related to the length of psychotic episode. Recent research has suggested that this is not the case[26] although further investigation is still ongoing.
Functional brain scans have revealed that the areas of the brain that react to sensory perceptions are active during psychosis. For example, a PET or fMRI scan of a person who claims to be hearing voices may show activation in the auditory cortex, or parts of the brain involved in the perception and understanding of speech.[27]
On the other hand, there is not a clear enough psychological definition of belief to make a comparison between different people particularly valid. Brain imaging studies on delusions have typically relied on correlations of brain activation patterns with the presence of delusional beliefs.[28]
One clear finding is that persons with a tendency to have psychotic experiences seem to show increased activation in the right hemisphere of the brain.[29] This increased level of right hemisphere activation has also been found in healthy people who have high levels of paranormal beliefs[30] and in people who report mystical experiences.[31] It also seems to be the case that people who are more creative are also more likely to show a similar pattern of brain activation.[32] Some researchers have been quick to point out that this in no way suggests that paranormal, mystical or creative experiences are in any way ''by themselves'' a symptom of mental illness, as it is still not clear what makes some such experiences beneficial whilst others lead to the impairment or distress of diagnosable mental pathology. However, people who have profoundly different experiences of reality or hold unusual views or opinions have traditionally held a complex role in society, with some being viewed as kooks, whilst others are lauded as prophets or visionaries.
Psychosis has been traditionally linked to the neurotransmitter dopamine. In particular, the dopamine hypothesis of psychosis has been influential and states that psychosis results from an overactivity of dopamine function in the brain, particularly in the mesolimbic pathway. The two major sources of evidence given to support this theory are that dopamine-blocking drugs (i.e. antipsychotics) tend to reduce the intensity of psychotic symptoms, and that drugs which boost dopamine activity (such as amphetamine and cocaine) can trigger psychosis in some people (see amphetamine psychosis).[33]
The connection between dopamine and psychosis is generally believed to be complex. While antipsychotic drugs immediately block dopamine receptors, they usually take a week or two to reduce the symptoms of psychosis. Moreover, newer and equally effective antipsychotic drugs actually block slightly less dopamine in the brain than older drugs whilst also affecting serotonin function, suggesting the 'dopamine hypothesis' may be oversimplified.[34] Soyka and colleagues found no evidence of dopaminergic dysfunction in people with alcohol-induced psychosis[{{cite journal | last = Zoldan | first = J. | coauthors = G. Friedberg, M. Livneh, and E. Melamed. | year = 1995 | month = July | title = Psychosis in advanced Parkinson's disease: treatment with ondansetron, a 5-HT3 receptor antagonist | journal = Neurology | volume = 45 | issue = 7 | pages = 1305-1308 | id = ]
Psychiatrist David Healy has criticised pharmaceutical companies for promoting simplified biological theories of mental illness that seem to imply the primacy of pharmaceutical treatments while ignoring social and developmental factors which are known to be important influences in the aetiology of psychosis.[35]
Some theories regard many psychotic symptoms to be a problem with the perception of ownership of internally generated thoughts and experiences.[36] For example, the experience of hearing voices may arise from internally generated speech that is mislabeled by the psychotic person as coming from an external source.
Treatment
The treatment of psychosis often depends on what associated diagnosis (such as schizophrenia or bipolar disorder) is thought to be present. However, the first line treatment for psychotic symptoms is usually a neuroleptic (also termed 'antipsychotic') medication, and in some cases hospitalisation. There is growing evidence that cognitive behavior therapy[37] and family therapy[38] can be effective in managing psychotic symptoms. When other treatments for psychosis are ineffective, electroconvulsive therapy (ECT) (aka shock treatment) is sometimes utilized to relieve the underlying symptoms of psychosis, such as depression or schizophrenia. There is also increasing research suggesting that Animal-Assisted Therapy can contribute to the improvement in general well-being of people with schizophrenia.[ Animal-assisted therapy ameliorates anhedonia in schizophrenia patients, , I., Nathans-Barel, Psychotherapy and Psychosomatics, 2005 ]
Further reading
★ Sims, A. (2002) ''Symptoms in the mind: An introduction to descriptive psychopathology (3rd edition)''. Edinburgh: Elsevier Science Ltd. ISBN 0-7020-2627-1
Personal accounts
★ Dick, P.K. (1981) ''VALIS''. London: Gollancz. [Semi-autobiographical] ISBN 0-679-73446-5
★ Hinshaw, S.P. (2002) ''The Years of Silence are Past: My Father's Life with Bipolar Disorder''. Cambridge: Cambridge University Press.
★ Jamison, K.R. (1995) ''An Unquiet Mind: A Memoir of Moods and Madness''. London: Picador.
ISBN 0-679-76330-9
★ Schreber, D.P. (2000) ''Memoirs of My Nervous Illness''. New York: New York Review of Books. ISBN 0-940322-20-X
★ McLean, R (2003) ''Recovered Not Cured: A Journey Through Schizophrenia''. Allen & Unwin. Australia. ISBN 1-86508-974-5
★ The Eden Express by Mark Vonnegut
★ James Tilly Matthews
★ Saks, Elyn R. (2007) ''The Center Cannot Hold -- My Journey Through Madness''. New York: Hyperion. ISBN 978-1-4013-0138-5
Links
★ Apparitional experience
★ Delusional disorder
★ Monothematic delusions
★ Jerusalem syndrome
★ Clinical Lycanthropy
★ Soteria
★ Hallucinations in the sane
References
1. ''KMLE Medical Dictionary Definition of psychosis'' The American Heritage Stedman's Medical Dictionary
2. Dick, P.K. (1981) ''VALIS''. London: Gollancz. ISBN 0-679-73446-5
3. Psychosis: from mental disorder to disease concept., , M D, Beer, Hist Psychiatry,
4. Online Etymology Dictionary
5. American Psychiatric Association. ''Diagnostic and Statistical Manual of Mental Disorders, Fourth edition - Text Revision'' (Published by the American Psychiatric Association, 2000).
6. Jacobson J.L. and A.M. Jacobson, eds. ''Psychiatric Secrets'' (Philadelphia: Hanley and Belfus, 2001)
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Fallon BA, Nields JA. "Lyme disease: a neuropsychiatric illness". Am J Psychiatry. 1994 Nov;151(11):1571-83.
8. Hess A, Buchmann J, Zettl UK, Henschel S, Schlaefke D, Grau G, Benecke R."Borrelia burgdorferi central nervous system infection presenting as an organic schizophrenialike disorder". Biol Psychiatry. 1999 Mar 15;45(6):795.
9. van den Bergen HA, Smith JP, van der Zwan A. "Lyme psychosis". Ned Tijdschr Geneeskd. 1993 Oct 9;137(41):2098-100.
10. Kararizou E, Mitsonis C, Dimopoulos N, Gkiatas K, Markou I, Kalfakis N. "Psychosis or simply a new manifestation of neurosyphilis?" J Int Med Res. 2006 May-Jun;34(3):335-7.
11. Brooke D, Jamie P, Slack R, Sulaiman M, Tyrer P. "Neurosyphilis--a treatable psychosis". Br J Psychiatry. 1987 Oct;151:556.
12. Lesser JM, Hughes S. "Psychosis-related disturbances. Psychosis, agitation, and disinhibition in Alzheimer's disease: definitions and treatment options." Geriatrics. 2006 Dec;61(12):14-20. Review.
13. Wedekind S."Depressive syndrome, psychoses, dementia: frequent manifestations in Parkinson disease" MMW Fortschr Med. 2005 Jun 2;147(22):11. German.
14. Adult-onset vanishing white matter leukoencephalopathy presenting as psychosis, Denier C, Orgibet A, Roffi F, Jouvent E, Buhl C, Niel F, Boespflug-Tanguy O, Said G, Ducreux D, , , Neurology, 2007
15. [Metachromatic leukodystrophy simulating schizophrenia-like psychosis], Hermle L, Becker FW, Egan PJ, Kolb G, Wesiack B, Spitzer M, , , Der Nervenarzt, 1997
16. Metachromatic leukodystrophy: a model for the study of psychosis, Black DN, Taber KH, Hurley RA, , , The Journal of neuropsychiatry and clinical neurosciences, 2003 free full text
17. Adult metachromatic leukodystrophy: disorganized schizophrenia-like symptoms and postpartum depression in 2 sisters, Kumperscak HG, Paschke E, Gradisnik P, Vidmar J, Bradac SU, , , Journal of psychiatry & neuroscience : JPN, 2005 free full text
18. Official Journal of American Pediatrics - PEDIATRICS Vol. 108 No. 3 September 2001, p. e52
19. Ettinger AB. "Psychotropic effects of antiepileptic drugs". Neurology. 2006 Dec 12;67(11):1916-25.
20. http://ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&list_uids=3060884 Psychiatric side effects attributed to phenylpropanolamine, ''Pharmacopsychiatry'' 1988 Jul; 21(4):171-81
21.
22. hallucinate
23. Auditory hallucinations: a comparison between patients and nonpatients
24. Encephalographic studies in mental disease., , M T, Moore, American Journal of Psychiatry,
25. Neuroanatomical abnormalities before and after onset of psychosis: a cross-sectional and longitudinal MRI comparison., , C, Pantelis, Lancet,
26. Untreated initial psychosis: relation to cognitive deficits and brain morphology in first-episode schizophrenia., , BC, Ho, American Journal of Psychiatry,
27. Copolov DL, Seal ML, Maruff P, Ulusoy R, Wong MT, Tochon-Danguy HJ, Egan GF. (2003) Cortical activation associated with the experience of auditory hallucinations and perception of human speech in schizophrenia: a PET correlation study. ''Psychiatry Res'', 122 (3), 139-52. PMID 12694889.
28. Bell, V., Halligan, P.W. & Ellis, H.D. (2006) A Cognitive Neuroscience of Belief. In P.W. Halligan & M. Aylward (eds) ''The Power of Belief''. Oxford: Oxford University Press.
29. Lateralized hemispheric dysfunction in the major psychotic disorders: historical perspectives and findings from a study of motor asymmetry in older patients., , JB, Lohr, Schizophrophrenia Research,
30. Brain electric correlates of strong belief in paranormal phenomena: intracerebral EEG source and regional Omega complexity analyses., , D, Pizaagalli, Psychiatry Research,
31. Temporal lobe signs: electroencephalographic validity and enhanced scores in special populations., , K, Makarec, Perceptual and Motor Skills,
32. Are creativity and schizotypy products of a right hemisphere bias?, , S, Weinstein, Brain and Cognition,
33. Kapur S, Mizrahi R, Li M. (2005) From dopamine to salience to psychosis - linking biology, pharmacology and phenomenology of psychosis. ''Schizophr Res'', 79 (1), 59-68. PMID 16005191
34. Jones, H. M., & Pilowsky, L. S. (2002) Dopamine and antipsychotic drug action revisited. ''British Journal of Psychiatry'', 181, 271-275. PMID 12356650
35. The Creation of Psychopharmacology, , David, Healy, Harvard University Press, , ISBN 0-674-00619-4
36. The perception of self-produced sensory stimuli in patients with auditory hallucinations and passivity experiences: evidence for a breakdown in self-monitoring., , SJ, Blakemore, Psychological Medicine,
37. The future of cognitive-behavioural therapy for psychosis: not a quasi-neuroleptic., , M, Birchwood, British Journal of Psychiatry,
38. Psychological interventions in early psychosis., , G, Haddock, Schizophrenia Bulletin,
External links
★ Understanding psychotic experiences from mental health charity Mind
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