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20 October 2012

Psychosis, Neurosis and Brief Reactive Psychosis, what are the differences?

By Samuel Blakemore


Examples of illnesses categorised as psychosis might be Bipolar disorder or Schizophrenia. These sorts of illnesses are characterised by hallucinations, delusions, serious defects in judgement and other cognitive processes and an inability to evaluate objectively. Any disorder that causes one or more of the above could be classed as a psychosis as it is a broad term that refers to a range of mental illnesses.

The encyclopedia Britannica 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'

Neurosis differs from psychosis in that it generally refers to non-psychotic mental illnesses that trigger feelings of distress and anxiety and but do not prevent rational thought, they may impair but not prevent normal functioning. A large variety of mental and physical symptoms such as anxiety, phobias, compulsions and bodily tics may be described as neuroses and are all characterised by having no clear neurological or organic cause.

Sigmund Freud used the term 'Anxiety Neurosis' to describe mental illnesses with defining features of distress or extreme anxiety. However the term neurosis was first coined in the 1700's by the Scottish doctor William Cullen who used it to refer to what he described as disorders of 'sense and motion' that he believed were caused by 'a general affection of the nervous system'. He used the term in relation to a range of different disorders that could not be explained with physiological causes.

Neurosis is almost never treated with medication but hypnotherapy and psychotherapy have been used extensively in the control and treatment of neurosis. They have both been shown to be extremely effective in such areas as the control of habits, compulsions or phobias and for stress management.

Brief Reactive Psychosis is characterised by the same symptoms as psychosis, such as delusions, hallucinations, disorganised speech and catatonic behaviour. To be termed brief reactive psychosis the symptoms must be present for more than a day but less than a month and for the person to then return to previous normal functioning.

Extreme stress or trauma in a person's life can be a cause of brief reactive psychosis but often episodes can occur suddenly and without any obvious trigger or reason. It has been suggested that there is a hereditary vulnerability to the condition but this has not been proven. Often similar symptoms can be triggered by drug or alcohol abuse but if this is the cause then by definition they cannot be termed brief reactive psychosis.

Often a preliminary diagnosis of brief reactive psychosis is made in people showing symptoms of psychosis only for it to be revised to another psychotic disorder (more often than not Schizophrenia) if the symptoms continue for more than one month. It is most likely to occur in adults aged in their 20's, 30's and 40's and is twice as common in women as in men.

The prognosis for the condition is good as, by definition, the symptoms go away within one month. However, due to the nature of psychotic behaviour, it can often lead to violence, self-harm or sometimes suicide. Clearly, if any of these is a risk then a person may need to be admitted to hospital.

Anti-psychotic medication can be used to control the symptoms and people experiencing the condition can have recurrent episodes in response to further stress.

Psychotherapy is known to be an effective treatment in dealing with the emotional stress that triggered the episode, and in helping the person establish coping strategies to minimise the affects of future stressful situations to prevent recurrence.

Hypnotherapy is contra-indicated in the treatment of all psychosis, however psychotherapy is being looked on more and more as a vital part of an integrated treatment approach as it is thought that 1 in 5 of all patients with long term psychotic conditions do not respond solely to to medication.




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