Schizophrenia PET scan http://www.nih.gov/news/pr/jan2002/nimh-28.htm
Schizophrenia vs Psychosis
The Diagnostic and Statistical Manual of Mental Disorders by the American Psychiatric Association is the bible that decides what symptoms fall under what medical diagnosis. The DSM-IV-TR has given exact criteria that must be met by patients to be diagnosed as suffering from bipolar disorder, schizophrenia, depression, anxiety neurosis, etc.
The DSM defines schizophrenia as a disorder characterized by impaired thought process, poor emotional responsiveness, distorted perception and disorganised speech. A person must meet the following criteria of DSM-IV to be classified as a schizophrenic-
- Signs for at least 6 months continuously and symptoms for at least a month.
- Significant impact on social interaction and occupation.
- 2 or more of the following symptoms for most days in a month- Hallucinations, disorganized speech, delusions, poor emotional response, poor speech, lack of motivated activity.
Psychosis is essentially a broad term for presence of symptoms like hallucinations and delusions. Examination for all possible physical disorders, psychiatric disorders and side-effects of drugs or medications using thorough history-taking, clinical examination, blood tests and imaging procedures leads to a diagnosis of psychosis. Technically speaking, psychosis implies an impaired perception of reality.
The exact cause of schizophrenia is not known but environmental factors along with genetics are thought to bring about this derangement of thought. The dopamine theory says that lack of dopamine due to shrinking of certain parts of the brain is responsible for schizophrenia. Exact proof for the same isn’t available. The cause of psychosis can be numerous drugs like alcohol, cannabis, amphetamines, brain tumors/cysts, stroke, epilepsy, HIV affecting the brain, Parkinson’s disease, Alzheimer’s disease, schizophrenia, etc.
Symptoms of schizophrenia include positive symptoms like hallucinations, delusions, disorganised thought and speech and negative symptoms like anhedonia (lack of desire to do things for happiness), lack of or poor emotional responsiveness towards people and situations, social withdrawal, lack of attention to personal appearance and hygiene, lack of judgement and poverty of motivation. There are 5 subtypes of schizophrenia- paranoid, disorganized, catatonia, undifferentiated and residual. Psychosis is a part of schizophrenia but not vice-versa. Hallucinations and delusions are the chief symptoms of psychosis and schizophrenia is just one of the possible reasons for it.
Diagnosis of schizophrenia is done by the criteria laid above. Blood tests and imaging can be used only to exclude other medical conditions, use of drugs that might mimic symptoms of schizophrenia. Similarly, psychosis is a diagnosis of exclusion of other medical conditions.
Treatment for both schizophrenia and psychosis is using anti-psychotic medications like risperidone, clozapine etc. Additionally, social interventions like family therapy, cognitive behavioural therapy, and community help might all help in reducing the social withdrawal and occupational dysfunction of schizophrenia. Therapy for psychosis involves removing any offending substance abuse and treating a physical medical condition that might causing the psychiatric symptoms.
Take home pointers:
Psychosis is a psychiatric condition manifesting as impaired thought and perception, hallucinations and delusions. Schizophrenia is a psychiatric disease characterized by psychosis as well as negative symptoms like lack of motivation and need for pleasure, lack of emotions and judgement, disorganisation of thought and behaviour.
The exact causes for schizophrenia are not known. Psychosis can occur due to alcohol, drugs, medical conditions like hypothyroidism, mania, etc.
Diagnosis of both is by exclusion of physical conditions, drug abuse, etc using blood tests, imaging procedures and DSM-IV criteria.
Schizophrenia is incurable but manageable using anti-psychotics and help from family and community. Therapy for psychosis depends on the cause.
If you feel that you are suffering from either Psychosis or Schizophrenia it is really important that you seek medical attention. Through early detection you will have a higher chance of leading a fulfilling life.