Causes of symptoms of mental illness were customarily classified as "organic" or "functional". Organic conditions are primarily medical or pathophysiological, whereas, functional conditions are primarily psychiatric or psychological.
The DSM-IV-TR no longer classifies psychotic disorders as functional or organic. Rather it lists traditional psychotic illnesses, psychosis due to General Medical conditions, and Substance induced psychosis.
Functional causes of psychosis include the following:
- brain tumors
- drug abuse amphetamines, cocaine, alcohol among others
- brain damage
- schizophrenia, schizophreniform disorder, schizoaffective disorder, brief psychotic disorder
- bipolar disorder (manic depression)
- severe clinical depression
- severe psychosocial stress
- sleep deprivation
- some focal epileptic disorders especially if the temporal lobe is affected
- exposure to some traumatic event (violent death, etc.)
- abrupt or over-rapid withdrawal from certain recreational or prescribed drugs
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. 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.
Vitamin B12 deficiency can also cause symptoms of mania and psychosis.
Vitamin D deficiency can cause altered thinking and psychosis.
Genetics may also have a role in psychosis. The Genain quadruplets were identical quadruplets who were all diagnosed with schizophrenia.
Psychosis arising from "organic" (non-psychological) conditions is sometimes known as secondary psychosis. It can be associated with the following pathologies:
- neurological disorders, including:
- electrolyte disorders such as:
- Adult-onset vanishing white matter leukoencephalopathy
- Late-onset metachromatic leukodystrophy
- Cerebral involvement of scleroderma (a single case report).
- Hashimoto's encephalopathy, an extremely rare condition (about 100 reported cases).
Psychosis can even be caused by apparently innocuous ailments such as flu or mumps.
Psychoactive drug use
Various psychoactive substances (both legal and illegal) have been implicated in causing, exacerbating, and/or precipitating psychotic states and/or disorders in users.
Some medications such as bromocriptine and phenylpropanolamine may also
cause or worsen psychotic symptoms.
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