Statistically, around one percent of Germans will suffer from a psychosis at least once in their lives. However, the term itself is very complex and must not necessarily be confused with schizophrenia, which is very often the case. Nowadays, a psychotic illness no longer has to mean a devastating diagnosis. A psychso is to be distinguished from a neurosis.


What is psychosis?

The term psychosis is an umbrella term, whereby a distinction is made between organic and non-organic psychoses, but also between affective psychoses and psychoses from the schizophrenic spectrum. See topbbacolleges for Definitions of Holt-Oram Syndrome.

Organic psychoses can be triggered, for example, by a brain injury (e.g. craniocerebral trauma). Non-organic psychoses, in turn, include both manic-depressive episodes, so-called schizoaffective disorders (disorders of emotional experience) and psychoses from the schizophrenic spectrum.

Characteristic of all psychoses is always a persistent or temporary loss of reality (hearing voices, either excessively overestimating or underestimating oneself, delusions, etc.). The term is therefore very comprehensive and differential diagnoses for a more detailed determination of the clinical picture are essential.


Science is currently based on a vulnerability-stress model as the cause model for psychoses. According to this, some people are more sensitive (more vulnerable, more vulnerable) than others and tend to develop a psychosis in certain situations (e.g. prolonged stress). This model correctly includes the genetic aspects as it refers to the fact that not everyone develops psychosis under the same circumstances. For this reason, it is also a fact that the use of drugs such as hashish leads to psychosis in some people, but not in others.

Overall, drug use, difficult social conditions, ongoing stress, traumatic experiences and strong genetic characteristics can all be the cause of a psychosis. However, it is usually a mixture of several factors. It has now been established that when a psychosis breaks out, the brain metabolism of those affected is not in balance.

In particular, too much of the messenger substance dopamine is held responsible for a psychosis. Of course, social components or drug consumption also have an effect on the dopamine metabolism.

Typical psychoses

  • schizophrenia
  • mood disorders
  • depressions
  • drug psychosis

Symptoms, Ailments & Signs

Psychoses include a very extensive repertoire of symptoms and are therefore difficult to standardize. Nevertheless, there are frequently occurring characteristics of the disease. In the early stages, patients suffer from increasing nervousness and lack of concentration.

This also includes slightly pronounced communication problems when communicating with other people. Blocked thinking or a downright flood of incoherent thoughts also impair intellectual performance. Later, delusions and hallucinations manifest themselves.

People with psychosis have an unusually high level of distrust, hear voices in their heads, and feel they are constantly being watched by real or imaginary people. In the case of the ego disorder, sufferers become convinced that other people hear their thoughts and influence them in a targeted manner. Great irritability or a conspicuous lack of emotion occur as a result.

In severe cases, this leads to hostility and aggression towards fellow human beings or the environment. Patients often develop an unusual interest in content with a mystical background or follow a strongly religious path in life. The symptoms do not always gradually worsen. They can also come as a complete surprise and quickly subside. Social contacts also suffer from the strange changes in behavior. People in the direct environment often perceive these as unreasonable or threatening and are therefore increasingly withdrawing from those affected.

course of the disease

Statistically, about a third of those affected experience a psychosis only once in their life, the second third falls ill twice or more often and in the last third the clinical picture becomes chronic and manifests itself as permanent schizophrenia.

Normally, a psychosis announces itself when those affected initially perceive their environment as foreign, feel strange and cannot explain it properly. As a result, the person concerned tries to put together a therapy in order to explain what is happening. This is usually the beginning of the delusions and loss of reality.

This, in turn, can lead to those affected perceiving their environment in a hostile manner and may therefore become violent – after all, they are the victims of an alleged “conspiracy”.


Psychoses, especially hallucinations and delusions, are always frightening for the patient himself and his social environment, which is why they should always be treated. However, psychotic disorders usually only become problematic when the person affected can no longer cope with their job and everyday life on their own due to the illness or when they pose a danger to themselves or others.

Complications result in particular from actions that endanger oneself and others and insufficient care of one’s own body. Psychotic disorders also make people more likely to abuse alcohol and other drugs, which can worsen the symptoms of the psychosis. Hallucinations often take on extreme forms under the influence of drugs. Here there is a risk that the patient will seriously injure himself while fleeing from what he sees, or that he will take countermeasures that also endanger others.

In severe cases, it can also happen that the patient attempts suicide in order to escape a supposedly worse danger. Delusions can be so severe, especially with drug abuse, that patients attempt to fly or walk on water, resulting in fatal injuries or drowning.

When should you go to the doctor?

People who exhibit behavioral abnormalities should be monitored further. A distinction must be made between personality traits and real disorders. If generally applicable social rules are constantly disregarded or seemingly deliberately ignored, a doctor’s visit should be made. Unpunctuality, baseless insults, perception disorders or uncontrolled actions are alarming signs of an illness. If dealing with other people regularly triggers conflicts, discomfort or fear in the other person, a check-up visit with a doctor or therapist is indicated.

Hearing voices, promptings from an imaginary power, or seeing objects that are not there is considered worrying. The indications are to be distinguished from spiritual or religious perceptions. In the case of a psychosis, the person affected does not behave in accordance with the social norm. He overreacts, has impulse control problems, behaves in a way that harms himself and others. If he becomes a danger to himself or the environment, an emergency service must be alerted.

Those affected cannot fulfill their everyday obligations because of their complaints. If drug-induced behavioral disorders are identified, medical attention is required. A doctor should be consulted in the event of withdrawal behavior, listlessness, loss of appetite or a depressive appearance. Problems with concentration or attention as well as delusions should also be checked out.

Treatment & Therapy

Psychoses are usually treated in hospital with neuroleptics. In contrast to the medicines used in earlier decades, the so-called atypical neuroleptics of the newer generation are preparations with fewer side effects, which is why they are preferably used for therapy. A large number of new neuroleptics have come onto the market in recent years.

In the case of a psychosis, however, psychotherapy is necessary in addition to drug therapy. The right medication and appropriate psychotherapy are often the key to success, ie to the cessation of the psychosis. Above all, there is no alternative to drug therapy; psychotherapy has only proven effective in combination with the right medication. It is now considered outdated to only want to heal a psychosis with psychoanalysis or only with psychotherapy.

In order to find the right drug or the right combination of drugs, it is often only possible to feel around and try it out, since psychoses and metabolic processes in the brain run very differently. However, the drugs available on the market are usually very effective, which was not necessarily the case with the older generation of neuroleptics.

In the acute phase of a psychosis, hospitalization in a psychiatric clinic is often necessary.


In order to prevent psychosis, it is important not to overdo it, which means keeping stress at bay and solving social problems. Prevention also includes not consuming drugs, because after all nobody knows whether they have a genetic disposition to a psychosis that can be caused by intoxicants.

In particular, people who have already experienced one or more psychoses should use their strength carefully and never take drugs. Also, it is necessary to regularly take the prescribed medications and regularly consult a specialist to avoid recurrence.