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Add ICU psychosis

Requesting that someone add "ICU psychosis" to the article.

Hi SueNami,

I think 'ICU psychosis' is a bit of a misnomer (albeit a commonly used one) as it usually refers to a state of delirium. Nevertheless, it might be useful to add a section on the more esoteric uses of the term 'psychosis' in the medical literature (such as so-called 'airport psychosis') and a note on the fact that the term may be used more loosely in these situations.

- Vaughan 21:17, 9 November 2005 (UTC)

The article is lovely!

Is there a cure, I can't be bothered to read the above paragraphs to find out According to R.D. Laing, psychosis itself could be the cure.

older entries

These really don't have anything to do with psychosis

The Problem of Defining Sanity for a discussion of the problems of defining reality in this context. This article, however, is fatally flawed in that sanity is a legal term and not a medical one
see the works of the science fiction author Philip K. Dick for a view from inside (Dick suffered from psychotic syptoms throughout his later life)

Readded line distinguishing bipolar and schizophrenia. It's rare for someone with schizophrenia to appear completely normal between psychotic episodes unless they are medicated. It's rather common for this to happen with people with bipolar disorder.

Was Joan of Arc psychotic, according to the article's definition? Shall we mention this in the article?

I suspect this question was written a couple of years ago, but to answer for the current editors - there was a school of scholarship in the twentieth century that proposed various psychological explanations for Joan of Arc's religious visions. This view was by no means universal among historians. Significantly, the people who met her during her lifetime often marveled at her mental acuity. It wouldn't be possible to maintain NPOV in this article with a short mention and an adequate treatment would probably be too digressive for an page devoted to psychosis. Durova 21:44, 2 March 2006 (UTC)

We could include a number of other prophets in this question Fred Bauder 13:25, 3 March 2006 (UTC)

Could someone include a citation for this and include the fact that this view is not generally accepted by psychiatrists?

Traditionally, psychosis was seen as arising exclusively from severe mental disturbance, however more recent evidence has shown that psychotic phenomena may be normally distributed throughout the population. It is usually only when someone becomes significantly distressed, or distresses others that psychotic experiences are considered as medical problems and become labelled as psychosis.

Yep, for example: Johns LC, van Os J. (2001) The continuity of psychotic experiences in the general population. Clinical Psychology Review, 21(8), 1125-41
http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11702510&dopt=Abstract Verdoux H, van Os J. (2002) Psychotic symptoms in non-clinical populations and the continuum of psychosis. Schizophrenia Research, 54(1-2), 59-65.
http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11853979&dopt=Abstract

Changed info on link between cannabis use and psychosis in light of recent review and additional studies publishes in January 2003 edition of Psychological Medicine. Of particular interest is the editorial which reviews the evidence for such a link: Degenhardt, L. (2003) Editorial: The link between cannabis use and psychosis: furthering the debate. Psychological Medicine, 33, 3-6. See also July 28. 2007 Lancet. —Preceding unsigned comment added by 71.139.7.248 (talk) 06:34, August 24, 2007 (UTC) Also reworded info on amphetamines / hallucinogens and psychosis at top of article as it was a little ambiguous and could be interpreted as saying that LSD / mescaline caused psychosis by nature of their effect. The LSD / etc experience is not considered psychotic in itself, but psychosis may arise as an unwanted long term side effect in certain individuals -- Vaughan

Could someone explain why those two paragraphs were removed? They contained useful information and I don't see anything objectable (or even controversial) in them.

No idea. Thanks for putting them back in.

"Psychosis is a psychiatric classification for a mental state in which the perception of reality is distorted." This is an all-time champion in the field of question-begging! Who is saying what reality is? --141.219.44.80 Trust me, if you'd ever had a psychotic episode and recovered, you wouldn't be asking that question. "What is reality" is a good and important question, but I can tell you that part of the answer is "it's not psychosis" Aaargh I am one who has been perceived as psychotic (by a psychiatrist) and to me the statement is very question-begging! (Please dont try telling me that my own perception of the statement is distorted). Laurel Bush 12:00, 31 Mar 2005 (UTC).

Just noticed that the psychosis article got added to the Brilliant Prose page. Well done to all who have contributed. Top teamwork.

Reference format

Hello all. I'm a newcomer to this article and thought it would be good to give references in the way I've been doing in the etymology section; can get back to the main text after clicking on the reference link. I haven't had time to sift through the references yet. The page Wikipedia:Citation templates may be useful. Thanks. I've made a start at this. Will come back to finish it off (unless someone else wants to). MP (talk) 12:56, 19 August 2006 (UTC)

Recent reference additions

Just a note for people adding new references to the article. Most are fantastic, but please read them through to get an idea of their signficance, as some are a bit outside of the mainstream literature for the point being referenced. For example, the article "Chronic phencyclidine administration induces schizophrenia-like changes in N-acetylaspartate and N-acetylaspartylglutamate in rat brain" is not great evidence that PCP is linked to psychosis. PMID 6725621 is a much better reference to support this claim (actually describes cases of people with phencyclidine-induced psychosis). Other than that, it's looking good and I'll sift through the article myself shortly. - Vaughan 06:47, 29 September 2006 (UTC)

Neurotoxicity?

In the section "Brain function", following is written:
"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."
Use of term "neurotoxic" as such is inappropriate here; neurotoxicity, or toxicity in general applies only to a substance i.e. a poison/toxin/venom. Toxicity is a characteristic of a substance, it can not be used to describe a condition. That means, that patological processes can't be described as "-toxic" unless they are caused by a poison/toxin. Thus, I suggest to change this term with "neurodegenerative", which, in my opinion, describes the situation related to psychosis better/more accurate than "neurotoxicity".--Spiperon 21:00, 25 October 2006 (UTC)

Hi there,

The progression of conditions can be described as neurotoxic when a toxin is theorised (even if it has not been identified) and there is an ongoing debate in the psychosis literature about whether psychosis is neurotoxic or not. e.g. see this review article. - Vaughan 06:41, 26 October 2006 (UTC)

Even in the quoted article abstract, it is stated that "...Synaptic plasticity, not neurotoxicity, appears to be the mediating process.". Neurotoxicity as such necessarily implies an action of a poison, not hypothesis about it. Neurodegeneration, in turn, may be an effect of neurotoxicity as well as other causes, and is therefore more appropriate, in my opinion.--Spiperon 07:17, 28 October 2006 (UTC)

Hi there,

As I mentioned before it is possible to talk about a condition being neurotoxic, if one suspects an unknown neurotoxin at work. The reason the article says "Synaptic plasticity, not neurotoxicity, appears to be the mediating process" is not because you can't talk about neurotixicity in this instance (if that were the case, how could you write a review article in a scientific journal using this exact terminology?) but because it argues that there is no evidence for neurotoxicity.

Neurodegenerative is not appropriate because the debate about whether idiopathic psychosis is neurodegenerative has been largely rejected (e.g. when Bleuler changed the named from dementia praecox to schizophrenia exactly because there was no evidence of neurodegeneration).

The sentence in the article "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" is accurate because it accurately describes the debate in the medical literature. If you don't agree with how the term is being used, this doesn't change the fact that it is being used in that way.

- Vaughan 10:02, 29 October 2006 (UTC)

Post-partum psychosis

(aka puerperal psychosis) Hi. Years ago I worked on a PPP research project at the Institute of Psychiatry in London. Whilst I note that two of the cited articles deal with this condition, there's nothing about it in the main text. Would someone who feels qualified to do so like to add something on PPP? I trained as a biochemist rather than a psychologist or psychiatrist, so I don't feel able to undertake this task. Thanks and regards, Notreallydavid 18:19, 25 December 2006 (UTC)

Begin NPOV dispute discussion

I've removed the following, I don't think it's worth trotting out Szasz's views in quite such detail in every entry on mental illness, as this is done in more detail in Thomas Szasz, schizophrenia and anti-psychiatry.

However, not everyone agrees. Dr. Thomas Szasz (author, The Manufacture of Madness) is perhaps the leading critic of the psychiatric profession. He says, "The term 'mental illness' refers to the undesirable thoughts, feelings, and behaviors of persons. Classifying thoughts, feelings, and behaviors as diseases is a logical and semantic error, like classifying the whale as a fish. ... The classification of misbehavior as illness provides an ideological justification for state-sponsored social control as medical treatment." This view can be seen as congruent with the work of Chomsky, whose works Necessary Illusions and Manufacturing Consent address thought control in democratic societies, but via propaganda instead of psychiatric treatment.

However, I think it's important to mention the general point, so I've replaced it with the following summary and included a little about R. D. Laing's criticisms as these are specific to psychosis.

Psychosis has been of particular interest to critics of mainstream psychiatric practice who argue that it may simply be another way of constructing reality and is not necessarily a sign of illness. For example, R. D. Laing has argued that psychosis is a symbolic way of expressing concerns in situations where such views may be unwelcome or uncomfortable to the recipients. Thomas Szasz has focused on the social implications of labelling people as psychotic, a label which he argues unjustly medicalises different views of reality so such unorthdox people can be controlled by society.

- Vaughan 09:54, 8 Jan 2004 (UTC) Some people may make that claim but they would be in essence saying that the entire field of psychology is wrong. There are clear medical features of these mental illnesses. Although psychology, like any science, is not and cannot be 100% correct (since perfection is denied to humans and their creations) none the less it is difficult for a doctor to waive her hand over someone and pronounce them as psychotic without proof and rational backing her diagonsis up. I am going to put 'inability to cope in ' back in. If we were smart we would get a copy of the DSM-4 (Diagnostic and Statistical Manual of Mental Disorders DSM-IV-TR) and quote them on their definition of psychosis is. Anyone diagnosed with mental illness must be done in accordance with this book. --ShaunMacPherson 15:47, 3 Mar 2004 (UTC)

you wrote "There are clear medical features of these mental illnesses". Really? What are the medical features and can you cite a source of this research and documentation?--Mark v1.0 08:48, 30 April 2007 (UTC)

I just noticed my secton on Szasz was removed. While I agree that a lengthy section is probably not warranted on every page on Psychiatry, I do not consider one paragraph to be excessive. Also, while I appreciate your inclusion of a Szasz link further down, your commentary is rather weak. To say he "has focused on the social implications" is secondary to the fact that he considers most aspects of Psychiatry fraudulent, IMHO. I think for NPOV reasons, something in the introduction should indicate that this branch of science is dubious. Bhuston 10:00, 9 Jan 2004 (UTC)

Hi Bhuston

My problem is not with the content, but it just seems a little too much detail in the psychosis article as Szasz's arguments don't apply to psychosis specifically, but are general to all of what others call mental illness. Since his arguments are covered more fully on other pages, I'm not sure of the value of including them in such detail here. The same with mentioning the opinion that psychiatry may be dubious. Surely the place for that is on the psychiatry or anti-psychiatry pages, rather than on every page about psychopathology ? However, I certainly think that the point is important, perhaps it might be worth including a bit mentioning that these arguments are better covered on his personal page (for example) ? - Vaughan 10:20, 9 Jan 2004 (UTC)

Hi Vaughan, In answer to the above, I disagree, as even the notion of "psychopathology" is considered by some (including me), BAD SCIENCE.

I'm adding the NPOV dispute tag until the following can be resolved:

General tone that psychiatry in general, and specifically this topic, are foregone conclusions based on sound science, which they are not. Simple thought experiments can show that axioms of psychiatry are opinion and not demonstratable scientific fact
weak mention of Szasz
"Psychosis has been of particular interest to critics of mainstream psychiatric practice who argue that it may simply be another way of constructing reality and is not necessarily a sign of illness." The premise here again is that "psychosis" is a scientifically valid concept, even amongst the anti-psychiatric people, which it is not.
The following argument is presented:
1. psychosis is a symptom of extreme mental illness
2. psychosis is a distorted view of reality
3. psychosis can be induced with LSD, mescaline, and marijuana
4. conclusion: LSD, mescaline and marijuana induce (symptoms of) mental illness
This is one possible interpretation, but not the only valid one, such as the interpreatation that hallucinogenic substances produce transcendental, entheogenic, shamanistic visions, or other mystical or religous states, which are quite valid and not to be thought of as "disease"
references to United States government sources supporting such "halucinogenic plants produce mental disease", which is really WOD propaganda

Really, I am of the anti-psychiatric camp. I've seen too many people, good friends of mine, forced into barbaric treatment, electrochocked, placed into restraints, removed from their homes, forced to take psychotropic drugs, etc. and worse, all against their will. These people were not threats. The laws are barbaric, and this is based on the bad scienctific premise that there is such a thing as "normal mental states", and that such things can be defined. I will not advocate removal of the NPOV dispute until these topics are addressed in a significant fashion. Bhuston 19:11, 14 Jan 2004 (UTC) --

There seems to be a difference between the field of psychology as a science, and the practice of psychology by scientists (psychologists, etc.).

Psychosis seems to be a well defined collection of symptoms (behavioural, chemical, and neurological). However, problems arise when trying to measure these symptoms in people and then assigning a diagnosis to them. Putting in a section on the practice of psychology and how these professionals incorrectly diagnosis and (abuse patients in the process of this incorrect diagnosis) with well backed up information / stats is useful.--ShaunMacPherson 16:03, 3 Mar 2004 (UTC)

--

Hi Buston

I think your points are good ones, but they apply to the classification of ALL MENTAL ILLNESS by psychiatrists, not just psychosis. I think this objection is quite fundamental when we are discussing where your points should go.

The premise here again is that "psychosis" is a scientifically valid concept, even amongst the anti-psychiatric people, which it is not.

I don't think anyone has ever argued that the classification of psychosis is based on science and the article certainly doesn't, as the classification of anything is a pre-scientific concept. In other words, to classify anything you have to set your criteria before-hand and then use science to see if things fit into your classification. So this is not a problem with psychosis per se, but with all types of classification, and especially with the classification of any type of human behaviour. For example, the classification of what consititutes remembering and therefore what is classified as amnesia is subject to exactly the same objection.

Psychosis is a concept (not a 'scientific fact' - i.e. the result of a tested hypothesis), and even anti-psychiatry advocates understand what is meant by it, even if they don't agree with the implications of its use.

Since it is the psychiatric implications you disagree with, rather than (I presume) the classifying human behaviour, I would argue that this is not the place for your original comments.

However, I think you've raised an important point mentioning hallucinogenic drugs, as this case shows some of the shortcomings of the article in describing the psychiatric concept. Experiences caused by such drugs are not considered to be a sign of psychosis because they are short term and abate when the body metabolises the drug out of the bloodstream. I think it should be mentioned in the article that psychosis is considered to be a a reaction beyond the immediate psychotropic influence of any drug and is in some way impairing or distressing.

references to United States government sources supporting such "halucinogenic plants produce mental disease", which is really WOD propaganda

? - I see no references to any government sources in the article.

- Vaughan 21:31, 14 Jan 2004 (UTC)

I'd like to removed the The neutrality of this article is disputed notice. Since it was added I think the points of contention have been addressed, however perhaps any objections can be voiced here. If none are made, I'll remove the notice during the next few weeks. - Vaughan 20:43, 6 Feb 2004 (UTC)

I've reverted the following additions to the introductory paragraph:

"there is extensive disorder of the personality"

"and an inability to effectively cope in society"

This is the traditional psychaitric view and is considered increasingly outdated. For example, see the Johns and van OS (2001) paper (reference 10), Bentall's work and the work by Fromme and Escher with the 'Hearing Voices Network'. i.e. Many people may fulfill the diagnostic criteria for a psychotic illness despite functioning perfectly well and maintaining an integrated personality. - Vaughan 13:34, 27 Feb 2004 (UTC) There is a reason why many psychotic people are in mental institutions: they cannot cope in society. To pretend that they could is disingenuous. If you prefer (after citing a scientific webpage that shows what % of psychotic paitents are able to cope so we can use the correct adjective) I'd have no objections to it being changed to '*sometimes accompanied* with an inability to cope in society' if a majority of people diagnosed with a psychotic illness can indeed function in society. --ShaunMacPherson 16:12, 3 Mar 2004 (UTC)

Hi there Shaun,

The DSM entry for psychosis is here. Specific diagnostic criteria is not outlined in the DSM because it is not a diagnosis in itself. It is a feature of, or a reaction to other conditions such as schizophrenia, or for example stress (in the case of brief reactive psychosis) and so on.

As for percentages, if we define psychosis as including hallucinations or delusions (as per the DSM, although it is not the final world in diagnosis, there are many other diagnostic systems used throughout the world), a study by Ohayon (2000) showed that 39% of people in the general population reported hallucinations. A study measuring delusional ideation in the general population by Peters et al (1999) reported that "The ranges of scores between the normal and deluded groups (i.e. inpatients) overlapped considerably".

The disintegration of personality and inability to cope in society is part of the diagnostic criteria for schizophrenia (see criteria B of the DSM-IV-TR criteria here) but psychosis can exist without these features and they do not define it in any way.

Very good then "an inability to cope in society" should be in the introduction since schizophrenia is a significant fraction of people with psychosis. As i've already stated if you want to add "sometimes/often/in the case of many disorders/etc. accompanied by...an inability to cope in society" then that is fine with me.

For example, delusional disorder is a psychotic disorder (see its DSM entry under 'Schizophrenia and Other Psychotic Disorders' here) but specifically states that general functioning should not be impaired.

Is delusional disorder a significant fraction of the psychosis patients like schizophrenia (~25%) is? I hope you are not using the exception to prove the rule.

In fact, there are even moves to remove the signs and symptoms of psychosis from the diagnostic criteria for schizophrenia, in favour of specific neurocognitive deficits. This is discussed at length in a recent article by Tsuang et al's and in Green's recent book Schizophrenia Revealed (ISBN 0393703347).

Yes, so?

Just because there are some people with psychosis who can't cope in society, doesn't mean that it is necessarily a defining feature of it. -

Vaughan 17:10, 3 Mar 2004 (UTC) Just because some people with psychosis can cope in society doesn't mean it isn't necessarily a defining feature of it. --ShaunMacPherson 11:21, 11 Mar 2004 (UTC)

Additionally, I found a study which found that suggests that the minority of people who fulfill the criteria for psychosis are clinically impaired in any way. Abstract here.

I propose removing the "disorder of the personality" and "inability to cope in society" description from the introductory paragraph as is seems neither supported by the DSM nor recent research. However, I think these are interesting points and would like to suggest a section titled "Is psychosis an illness ?" (or similar) where these points can be discussed, alongside the bits elsewhere in the article about Laing and Szasz's view of psychosis and Jfdwolff's suggestion incorporating non-psychiatric aetiologies into the article.

I'll make a start shortly, so please voice any objections here or edit once it's in place. - Vaughan 16:22, 8 Mar 2004 (UTC)

Secondary psychosis I've introduced a small list of diseases that can induce psychosis, e.g. Lupus Erythematosus and Sarcoidosis. I did not have the time to find a more complete list, but I felt this belonged here. Jfdwolff 08:57, 1 Mar 2004 (UTC)

Unfortunately, the list would be very long indeed as psychosis has been reported to occur in association with almost every form of disease known, including ones traditionally thought to be relatively benign and not usually associated with neurotoxicity, such as flu, mumps and rickets. In fact, almost any combination of 'psychosis' and another randomly selected disease will bring up a case on PubMed.

I'm also a little uncomfortable about the use of the term 'Somatic diseases' as it suggests that mental illnesses aren't located in the body which seems to smack of dualism for me.

So, I'm not entirely sure such a list would be useful. However, perhaps some others could give their views here ? - Vaughan 09:26, 1 Mar 2004 (UTC)

Thanks Vaughan, I'll be more specific. Of course any disease can also luxate psychosis (there's a seperate DSM code for this phenomenon). There are, however, some diseases which are very prone to cause psychosis. Up to 25% of all Lupus patients have a psychosis at some point through their disease, which is very high indeed. Most 'flu' patients do not get psychosis :-). The use of the word "somatic" is entirely because this is the way psychiatrists talk. Allright, the brain is also an organ, but psychiatry has benefitted immensely from the distinction of "psychiatric" and "somatic". The third axis in DSM diagnosis is reserved for so-called "somatic" diagnoses. Hope this clarifies my contributions. Jfdwolff 20:05, 1 Mar 2004 (UTC)

Hi again Jfdwolff,

Good point. Perhaps it would be better to have a 'top 10' or similar of conditions most associated with psychosis, rather than an open list as I fear it may simply be continuously added to over time and become increasingly useless as the list becomes excessively large and, like you say, full of rare cases.

Unfortunately, after a quick literature search has brought up nothing of obvious relevant that might provide this information, however I will continue looking both on and offline and see what I find. If you know of any such sources, please post them !

As to your second point, although psychiatry may have benefitted from the distinction between 'somatic' and 'psychiatric' in the past, I would argue it is becoming increasingly redundant. More importantly I don't think a wikipedia should simply uncritically reproduce psychiatric definitions, especially where they are confusing. Perhaps a note on 'secondary psychoses' and a mention of Tsuang et al's influential paper on etiology of psychosis might be informative on this issue ? - Vaughan 21:08, 1 Mar 2004 (UTC)

Hi Vaughan. Unfortunately I lack the time to compile an authoritive list of disorders associated with psychosis. Cerebral Lupus and Sarcoid definitely belong here, though. In order to meet with your objections, the header could be changed to read: "Non-psychiatric disease associated with psychosis" (to eliminate the "somatic" bit). Tsuang et al seem to focus mainly on the classification of schizophrenia, which - although the most important - is only one of the causes of psychosis. I would agree that this is an important reference, but more properly in the Schizophrenia entry. Jfdwolff 16:41, 3 Mar 2004 (UTC)

Hi Jfdwolff,

Excellent suggestion. I am in the process of compiling a list and will certainly add your information and perhaps you can check it over once completed? The Tsuang article is focused on the classification of schizophrenia but makes wider points about the separation of psychosis and schizophrenia. - Vaughan 17:11, 3 Mar 2004 (UTC)

Vaughan, I'm embarrassed to say that I've not properly read the Tsuang article, and I beg to understand what light it might shed on secondary psychosis. I've personally never heard of secondary schizophrenia, nor does it sound plausible. I'm very interested about your list! Jfdwolff 15:26, 5 Mar 2004 (UTC) Hi, It gives a suggestion for hearing voices - internal voices that are mislabeled. I've had a possible idea about that. You know when you leave on the microphone on voice recognition software, and it tries to make words out of background noise. The software makes sure it generates gramatically correct sentences. What if that is happening in real life? An over sensitive recognition system, combined with hearing what you think you should hear. I know this is offtopic, sorry about that. Does anyone know if this has been suggested, and is it a theory? Could this idea be added in someway? Thank you for your time. JohnFlux 19:22, 24 Apr 2004 (GMT)

What's the deal with the PC treatment? Is it taboo to call psychosis a disease/disorder/ailment?

It's not PC treatment. People have different definitions for disease and disorder. Some consider mental illness a disease, while others claim a persons non physical mind can not be diseased. Diseases have lab tests to detect them ,mental illness has no lab tests. Peoples injured souls have been directly linked with peoples physical brains in biological psychiatry.--Mark v1.0 08:55, 30 April 2007 (UTC)

Removed 'Hearing voices' section

I removed the following section that was recently added, as it seems to be someone's personal experience of psychosis. However, it reminded me that the article doesn't particularly address the magical thinking / apophenia aspect (see connections everywhere) very well, which probably needs a bit more elaboration. - Vaughan 07:49, 17 July 2006 (UTC)

Hearing Voices - Explained

Individuals that "Hear Voices", contrary to what's listed above, very rarely hear ACTUAL voices inside their head. More often than not, the term 'hearing voices' is used to explain a phenomena un-explainable by current medical knowledge; When going through a period of Mania, or Depression, it's common when experiencing psychosis to have a feeling of 'a greater power' controlling the things in daily reality. Things such as lights flickering, television reception, etc. When a person experiencing psychosis has racing thoughts (thoughts moving much faster than normal), often co-incedances are sought after as everything is believed to have meaning to a greater purpose. When certain things happen, such as say a poster comes loose from a wall and falls to the floor, it's believed by the psychotic person that 'the higher power', whatever it may be, caused the poster to fall, which then causes the attention of the psychotic person to start paying close attention to all their senses, looking for signs that the higher power is trying to tell them something. If for example they are wondering if they should go and get a drink of water because they are thirsty but are indecisive as they are currently engaged in an activity, the poster falling off the wall depending on where it is hung would be the determining factor on them getting a drink. If the poster was hung close to a sink or next to the fridge, it would be a 'sign' that they should get a drink. If it was opposite them, it would be perceived to continue their activity and ignore their bodies request for fluid.

Combine all external stimuli, from fans going on and off in an office space, to the volume level of a television program in between commercials, people experiencing psychotic symptoms often portray these stimuli as something/someone trying to communicate with them - hence being spoken to, aka, hearing voices.

I definitely agree with the removal of this text. It is clearly one person's guess as to what is happening. I know from my experiences with manic psychosis that I definitely heard voices speaking in complete clear sentences and seeming to come from specific locations around me, even though I could not locate the speaker. They were not nonspecific noises or stimuli that I interpreted as having meaning or being signs! I admit I do NOT know what was happening, but I remember the experiences very clearly. -- RTC 01:26, 12 June 2007 (UTC)

Hamlet and 'intentional psychosis'

Someone added the following to the intro, but as I've no idea what it means ('intentional psychosis'?), I've moved it here for discussion:

There are superficial forms of psychosis, for example the kind of "intentional psychosis" that Hamlet suffered in the Shakespeare play.

- Vaughan 08:11, 15 May 2007 (UTC) I did not see withdrawal from neuroleptics (discontinuation syndrome)in the list of things that cause psychosis. R. Tranter, D. Healy, Neuroleptic discontinuation syndromes, J. Psychopharmacology, 1998, 12(3), 306-311 — 24.177.111.117 (talk) 11:53, 5 September 2007 (UTC)

Psychoanalysis and Psychosis

I am replacing this entry in the historical section which Vaughan deleted. This is a valid historical entry outlining psychoanalysis as an alternative view on psychosis. Deleting it is no more than censoring the historical record 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 : —Opendish (talk • contribs) 23:50, 7 September 2007 (UTC)

This topic is also available in Arabic

This topic (Psychosis) is available in Arabic at this URL: http://ar.wikipedia.org/wiki/%D8%B0%D9%87%D8%A7%D9%86 but I couldn't find the place to link them together. Would some one experienced help with linking, please? Ai.unit 03:02, 19 September 2007 (UTC)

Done! Added ar:ذهان. As-Salāmu `Alaykum, CopperKettle 06:51, 19 September 2007 (UTC)

Larium (mefloquine)

This drug for malaria can cause psychosis and there are a lot of news articles concerning the miltary and travelers taking this drug and becoming mentally ill including killing people. Bronayur 03:01, 21 October 2007 (UTC)

BNF 53 lists psychosis as a side effect, but is does not say how frequent it occurs. Snowman (talk) 10:38, 30 November 2007 (UTC)

Mefloquine can be added under substances, psychosis is an uncommon but serious side effect of this medicine. a citation would be nice to put along with it, it anyone has one, many be a link to one of the news articles from aboveExpo512 (talk) 10:44, 30 November 2007 (UTC)

Document deleted

Lacan and Freud on the structure of psychosis : I deleted this document as it's not very clearly written and shouldn't have been in the main text anyway. A section on Lacan and Freud's theories would be very welcome though. —Preceding unsigned comment added by Camuser (talk • contribs) 01:40, 20 January 2008 (UTC)

psychosis and violence

There is a reference about psychotic people not being more violent than others. Both citations refer to "first episodes". I think that psychosis and particularlly acute psychosis is a significant risk factor for violence (along with intoxication and past history of violence). However I know this is controversial and I do not want to put up anything wtihout citations. Any help here?--Expo512 (talk) 09:34, 30 November 2007 (UTC)

There is a valid observation, that is logical. A psychosis (no fault to the patient) that originates by disease or drugs, can cause a paranoia of sorts. So the patient reacts to his or her alse sense of 'threat'.

It is sad that media does not explain this, why ? there must be a reason. Anyway, as noted this is a high importance subject and by what I read it is very well done. --Caesar J. B. Squitti : Son of Maryann Rosso and Arthur Natale Squitti 16:30, 14 August 2008 (UTC)

Much room for improvement

I think that the article is generally good and there are many references. I think that it can be improved a lot. there are several thinks that need to be made clearer: 1. There is no universally accepted definition of what is psychosis, even by current mental health professionals. A good reference is the first page of the 'psychotic disorders' chapter of the DSM-IV-TR. I think more of emphasis needs to be placed on the fact that psychosis it a broad concept. 2. The concept of "psychosis" is a very general sign or symptom, which may or may not be the sign of mental illness. 3. I'm not sure listing treatment of a symptom is really appropriate. It may be like listing the treatment for chest pain. Reasonable people would want to know if chest pain is related to the heart, the stomach, a muscle tear or another cause, before treatment. Really the treatment is for the underlying cause, and that should probably go in the corresponding articles.--Expo512 (talk) 08:46, 30 November 2007 (UTC)

Problem I see that many 'psychotic" episodes are the result of 'causes' that create mental illness symptoms. Much like a flu virus can cause light headness, a minor form of mental illness. Why this 'bridge is not made' is a question of education ?

--Caesar J. B. Squitti : Son of Maryann Rosso and Arthur Natale Squitti 16:33, 14 August 2008 (UTC)

Retrofit topic-year headers

21-Aug-2008: I have grouped older topics above using headers "Topics from 2003" (etc.) to emphasize age of topics. Older topics might still apply, but using the tactic of yearly headers to note the age helps avoid rehashing old news, without archiving any ongoing issues. Also, new topics are more likely to be added to the bottom, not top. Afterward, I moved several topics into date order. -Wikid77 (talk) 03:43, 21 August 2008 (UTC)

Paradoxical effects of Benzodiazepines

Hi there Caesarjbsquitti, I've looked at the articles you cite and they make only passing reference to psychosis and cite single case studies when they do. This information would seem to be much better suited in the benzodiazepine article, rather than the psychosis one, and owing to the strength of the evidence, is perhaps worth including in an abbreviated form. - Vaughan (talk) 14:20, 8 September 2008 (UTC)

Early intervention in psychosis

my first wikipedia - have now added article on early intervention. Help please. Cheers Earlypsychosis (talk) 12:47, 19 December 2008 (UTC)

Postpartum psychosis

I think it should be mentioned and a wikilink should lead to the article, but I'm not sure to what category it belongs. --CopperKettle 18:06, 12 February 2009 (UTC)

lack of insight deleted

this is the deleted section on insight. Five of the six references provided were for schizophrenia, not psychosis. Kept this section for review. Earlypsychosis (talk) 19:56, 14 March 2009 (UTC)

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 behavior. name=Carpenter_et_al_1973>Carpenter, William T., Jr., John S. Strauss, and John J. Bartko (December 21, 1973). "Flexible system for the diagnosis of schizophrenia: Report from the WHO international pilot study of schizophrenia". Science. 182 (4118): 1275–8. doi:10.1126/science.182.4118.1275. PMID 4752222. {{cite journal}}: Check date values in: |date= (help)CS1 maint: multiple names: authors list (link). Even in the case of an acute psychosis, people may be completely unaware that their vivid hallucinations and delusions are in any way "unrealistic". This is not an absolute, however; insight can vary between individuals and throughout the duration of the psychotic episode.

It was previously believed that lack of insight was related to general cognitive dysfunction name=Lysaker_et_al_1994>Lysaker, Paul H. (1994). "Insight and cognitive impairment in schizophrenia. Performance on repeated administrations of the Wisconsin Card Sorting Test". Journal of Nervous and Mental Disease. 182 (11): 656–60. PMID 7964675. {{cite journal}}: Unknown parameter |coauthors= ignored (|author= suggested) (help); Unknown parameter |month= ignored (help) or to avoidant coping style. name=Lysaker_et_al_2003>Lysaker, Paul H. (January 1, 2003). "Insight in schizophrenia: associations with executive function and coping style". Schizophrenia Research. 59 (1): 41–7. doi:10.1016/S0920-9964(01)00383-8. PMID 12413641. Retrieved 2006-10-22. {{cite journal}}: Check date values in: |date= (help); Unknown parameter |coauthors= ignored (|author= suggested) (help). Later studies have found no statistical relationship between insight and cognitive function, either in groups of people who only have schizophrenia, Freudenreich, Oliver (2004). "Insight into current symptoms of schizophrenia. Association with frontal cortical function and affect". Acta Psychiatrica Scandinavica. 110 (1): 14–20. doi:10.1111/j.1600-0447.2004.00319.x. PMID 15180775. Retrieved 2006-10-22. {{cite journal}}: Unknown parameter |coauthors= ignored (|author= suggested) (help); Unknown parameter |month= ignored (help) or in groups of psychotic people from various diagnostic categories. name=Cuesta_et_al_2006>Cuesta, Manuel J. (May 31, 2006). "Insight dimensions and cognitive function in psychosis: a longitudinal study". BMC Psychiatry. 6: 26–35. doi:10.1186/1471-244X-6-26. PMID 16737523. Retrieved 2006-10-22. {{cite journal}}: Check date values in: |date= (help); Unknown parameter |coauthors= ignored (|author= suggested) (help)CS1 maint: unflagged free DOI (link)

edited lead section

deleted this sentence and references

This disease link has led to the metaphor of psychosis as the 'fever' of CNS illness—a serious but nonspecific indicator. Tsuang MT, Stone WS, Faraone SV (2000). "Toward reformulating the diagnosis of schizophrenia". Am J Psychiatry. 157 (7): 1041–50. PMID 10873908. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link) DeLage, J. (1955). "[Moderate psychosis caused by mumps in a child of nine years.]". Laval Médical. 20 (2): 175–183. PMID 14382616. {{cite journal}}: Unknown parameter |month= ignored (help)

not good sentence for the lead section
reference is about the diagnosis of schizophrenia and a quick read of the abstract doesnt mention the line in sentence fever of CNS
1955 reference about mumps not the best

Earlypsychosis (talk) 08:18, 18 April 2009 (UTC)

classification of psychosis

this is an article about the concept of psychosis - not the DSM classification concept of psychosis. I propose either a rewrite to incorporate a more balanced view of psychosis (other than just diagnostic categories) or delete the section

Earlypsychosis (talk) 08:04, 13 March 2009 (UTC)

How about sketching out here, before you do it, the thrust of the rewrite you would like to do? DSM is an attempt to capture the consensus of the psychiatric community, so it's not clear to me that you can legitimately say it has NPOV issues -- but I'm not a psychiatrist and am open to being convinced. Looie496 (talk) 19:38, 13 March 2009 (UTC)

I'm new to wikipedia and havent read the discussion history on this page...but it does appear to me that there is a massive WP:content fork for mental health conditions -

some tend to simply follow a DSM format, or at least write with an underlying and unchallenged perspective of clinical psychiatry and diagnosis(sometimes with a brief criticism section)
others then write their alternative perspectives in other recovery model based articles.

This article on psychosis is a good example. The entire piece is almost entirely written from a DSM perspective, with a very strong balance toward clinical psychiatry. Kraepelin originally conceptualised mental disorders as distinct categories (e.g. Dementia praecox and manic depression) with their own underlying biological disease process. These views have had a major influence on psychiatry, and form the basis of the operational diagnostic criteria. Apart from the 4 lines in the introduction on psychosis in the general population and the history section - the inclusion of sections basically follows these diagnostic assumptions

symptoms tautological - (psychosis is a symptom?). Also unusual to say that psychosis lacks insight (psychosis by definition ?) and the citation does refer to schizophrenia. should remove this section. ( done Earlypsychosis (talk) 09:39, 15 March 2009 (UTC))
classification that only looks at DSM (without a challenge or NVOP note)
causes (all medical or drug - passing mention psychosocial stress, lacks a whole reference to psychological theories)
Pathophysiology (this reads like a schizophrenia reference - a quick check shows at least one is about schizophrenia and should be removed Ho, BC (2003). "Untreated initial psychosis: relation to cognitive deficits and brain morphology in first-episode schizophrenia". American Journal of Psychiatry. 160 (1): 142–8. PMID 12505813. {{cite journal}}: Unknown parameter |coauthors= ignored (|author= suggested) (help). Not sure why this topic gets its own section in addition to the causes section above.
treatments - dubious to make an emphasis on this, if a broader non clinical concept of psychosis is being considered

but all too easy to say what is not right...suggest the following sections:

Conceptualistion

mention differ views from clinical symptoms to range of experiences in general population and different disciplines views (psychiatry, psychology, anthropological or cultural?) The british psychological society report on psychosis [1] www.understandingpsychosis.com is a good comprehensive and peer reviewed source of information. Greene, T (2007). The Kraepelinian dichotomy: the twin pillars crumbling?. History of Psychiatry, Vol. 18, No. 3, 361-379

As a Clinical symptom

ie DSM category.

Continium of human experience

Need more content as per Hearing Voices Movement e.g Marius Romme and Bentall, R. (2006). Madness explained: Why we must reject the Kraepelinian paradigm and replace it with a 'complaint-orientated' approach to understanding mental illness Medical Hypotheses. 66, (2) 220-233.

Incidence

how common is it, clinical definitions, in general populations, how does it vary across cultures, gender, ethic variation, urban vs rural

Causes

include a mention of physical conditions - but dont create a massive list as per the current article. include trauma evidence - torture, prisoners of war, sensory deprivation, childhood sexual abuse

Treatments

might be dubious to include in this article if the broader concept of psychosis is considered

Earlypsychosis (talk) 07:29, 14 March 2009 (UTC)

The section appeared to have quite a bit of original research in it which I have deleted. It may need a further rewrite or even deleted altogether as has been suggested but I think that I have resolved the most glaring problems with it.--Literaturegeek | T@1k? 14:37, 26 March 2009 (UTC)

it wasn't original research. In fact, you deleted one of the only statements about psychosis as a symptom (and not an illness) - making it even more unbalanced, as per the tag. Maybe better to add a tag^{[citation needed]}. Earlypsychosis (talk) 09:53, 5 April 2009 (UTC)

I don't mind if you want to add back in about psychosis being a symptom, not an illness.--Literaturegeek | T@1k? 16:49, 5 April 2009 (UTC)

Yes psychosis can be a symptom, but we would most commonly use it as an adjective - saying 'psychotic symptoms' rather than as a noun. Psychotic symptoms can exist in mania, depression and as a brief reaction in some personality disorders (borderline and schizotypal in particular). Casliber (talk · contribs) 20:18, 5 April 2009 (UTC)

Looks like this has been resolved. Sorry for deleting it. I think the issue is how it is worded. Casliber do you think that it needs rewording further? I am not sure that it sounds right. If so feel free to give it a quick tweak. Maybe it should say something like,,,,,, psychotic symptoms or episodes can occur in several mental health disorders without a person meeting the criteria of having a psychotic disorder..... How does that sound?--Literaturegeek | T@1k? 20:27, 5 April 2009 (UTC)

Reword needed, but also need to include the perspective that psychosis can occur without distress or impairment of functioning - i.e. psychotic experiences that are not considered a clinical disorder - such as hearing voices. That is why I added the NPOV tag. Earlypsychosis (talk) 08:11, 6 April 2009 (UTC)

True true, people can hear voices without actually being psychotic. They can still be in touch with reality and not even be distressed by the voices. This subject is more complicated than what first meets the eye! Thank goodness I am not a psychologist or psychiatrist!!! ;-)--Literaturegeek | T@1k? 08:20, 6 April 2009 (UTC)

Maybe it should read "psychotic symptoms or episodes can occur without a person meeting the criteria of having a psychotic disorder."? Minus the mental health disorder.--Literaturegeek | T@1k? 08:20, 6 April 2009 (UTC)

Right - facts:

the psychoses are a group of disorders where the main disturbance is deterioration on function psychotic symptoms (AH, delusions or thought disorder, or catatonia)

they include schizophrenia, schizoaffective disorder, schizophreniform psychosis mainly, and psychoses secondary to meds or drugs.

One can also get psychotic symptoms in mood disorders and some personality disorders (postpartum psychosis is often seen as part of a mood disorder spectrum)

One can have nonpsychotic AH (hypnogogic and hypnopompic are normal), also occur in BPD, hwere they are often described as dissociative in character.

Yes the classification of psychosis has changed and evolved and it needs to be in the article - the definition used to be much broader in Kraepelin's day etc. and include what is now BAD and melancholic or major depression.

APART from classification, we have psychotic symptoms. Yes they can also occur in delirium and dementia, but we often don't call them that there, also character is different - eg visual hallucinations are not usually associated with schizophrenia.

Just some notes - that is how the term is seen psychiatrically these days. Casliber (talk · contribs) 10:24, 6 April 2009 (UTC)

right, more factors!

psychotic symptoms. common in the general population. might not result in decline in functioning. not widely considered within psychiatric profession
psychotic disorder. psychotic symptoms regarded as a clinical condition (ie where functioning is impaired)
formal psychotic conditions as defined by various manuals (DSM or ICD) Earlypsychosis (talk) 08:00, 9 May 2009 (UTC)

References to the "DSM-IV-TR" verge on jargon, confusing to the layperson. I've changed the reference to refer to the "most recent version of" the DSM and relegated "IV-TR" to a footnote. --Whoosit (talk) 15:10, 20 June 2009 (UTC)

Religious delusion?

Somebody who is familiar with the Moore & Gordon "audio essay" (whatever that is) cited here might want to double-check that the "Jesus's twin" statement actually is used in the context of delusions. Perhaps it is, but to me that sounds far more like a classic case of clanging. Also, on an unrelated note, somebody who is familiar with User:MiszaBot might want to get some archiving going on this page. The current format is a tad unwieldy. Cosmic Latte (talk) 17:09, 23 November 2009 (UTC)

ICU Psychosis

Somewhere in the beginning of this article it should be mentioned that no one knows the cause of psychosis in mental illness. A clear differentiation should be made between substance caused physical and biological mental conditions that have psychotic-like behavior and true psychosis with no known cause.

ICU Psychosis is not understood by physicians. Some claim it is delirium but others point to the fact that the delusional episode sometimes continues after the subject leaves the ICU. A very few victims have life long disability from ICU Psychosis. Understanding the cause of ICU Psychosis is critical to understanding psychotic mental states. While in the ICU patients do little besides daydream. In that eyes-open mental state they can subliminally detect movement around them as nurses and others approach. That is a description of Subliminal Distraction exposure. Subliminal Distraction is explained in college psychology under psychophysics. Although arising from the basic facts in the physiology of sight and hearing, it is little known by the general population. Visual Subliminal Distraction was discovered to cause mental breaks for office workers in the 1960's. Most victim quickly recover with no treatment once the stimulus of the subconscious from failed attempts to trigger the vision startle reflex stop. In psychology it is treated as something that happened once a long time ago. In Design it is understood to be a current problem but believed to cause only a harmless temporary episode that remits with no treatment. Once you understand it is a problem of human physiology you will realize it will happen any place you create the "special circumstances" of those 1960's office workstations. Similar psychotic mental events happen to those who perform too many Qi Gong sessions in a compact time frame. There too the concentration to use eyes-open meditation engages a mental state that allows threat-movement to be subliminally detected. It is difficult for some to conceive that the groups of moving meditating people are creating the circumstances for SD exposure. Beliefs that acolytes can throw Chee energy from their fingertips to strike others is psychotic but not recognized as such. This is one of the cases where it is believed the subject just has a different reality. In Kundalini Yoga the belief that you can overcome gravity by the will of your mind and levitate is also psychotic but again not recognized as such. Kundalini Yoga is another group exercise with eyes-open meditation and movement in peripheral vision. This is the same special circumstances as Qi Gong. Both exercises have been known for mental problems for about 3000 years. VisonAndPsychosis.Net is the first to propose a physical cause for the two exercise's mental events and bizarre beliefs. Since 1977 there have been studies in an attempt to explain why sitting in the audience at a seminar, The Forum, causes mental breaks. Landmark Education warns potential seminar participants about the mental problems but they do not understand why they happen. While attending the lecture or participating in group activities mental investment allows Subliminal Distraction exposure. Only a few have the mental events but there has been one murder of a postal worker caused by the psychotic episode from this seminar. The shooter recovered completely in one week and had no other episodes during his confinement in a mental institution. Significant in this seminar is that it is a classroom-like situation. No school is aware of this problem and they do not provide Cubicle Level Protection or warn students. There is no mention of this phenomenon or that it is unknown in medicine or psychiatry.

--Removing outside link per WP:SPAM. User has been repeatedly adding this website to drum up attention.-- Angryapathy (talk) 15:34, 30 November 2009 (UTC)

Researcher44 (talk) 17:52, 10 November 2008 (UTC)

This talk page should focus on discussion of the article. Since the material above does not appear to have been published except on a personal web site, it can't be used in the article, I'm afraid. looie496 (talk) 18:22, 10 November 2008 (UTC)

extreme?

explain immediately what is meant by "extreme form of consciousness" or I'll delete it as unrepresentative of the views of the scientific community, and an illdefined phrase unfairly weighted towards the views of a minority. if you know what consciousness is, let us know. if not, it's not teneble to ascribe magnitude to it. If you're about to give me some r.d. laing nonsense or give me the "arrogant ignorant scientist" spiel, then: don't. very kindest wishes 86.26.173.195 (talk) 02:07, 17 March 2010 (UTC) (colin reveley, sackler centre for consciousness science Univ. Sussex)

Differences from delirium

I think the introduction should say how psychosis is different from delirium.Stefan Udrea (talk) 15:20, 15 June 2011 (UTC)

Localisation of details (legality of certain drugs)

In the "Psychoactive drug use" section, the drugs are sorted into verious categories of legal drugs, and an "illegal drugs" category. I assume this refers to legality in America, where most users seem to be from, but this puts unnecessary bias on some readers, and it is plausible that these categories differ between English speaking countries, and therefore some sort of disclaimer should be made, or the categorisation should be scrapped altogether. 121.73.164.116 (talk) 04:15, 11 December 2008 (UTC) tr — Preceding unsigned comment added by 41.139.154.214 (talk) 05:51, 8 December 2011 (UTC)

Susac's syndrome ?

Susac's syndrome - seems to manifest as psychosis in some cases. --CopperKettle 05:42, 28 December 2011 (UTC)

Thought disorder

is thought disorder necessarily a symptom of psychosis? Might be more accurate to exclude from this article. Earlypsychosis (talk) 10:16, 5 April 2009 (UTC)

Not entirely clear what question you are asking. Is it "Can there be psychosis without thought disorder?" or "Can there be thought disorder without psychosis?"? Looie496 (talk) 16:40, 5 April 2009 (UTC)

It is a psychotic symptom, just as much as auditory hallucinations or delusions - eg hebephrenia (now disorganized schizophrenia) is a psychosis where the predominant symptom is thought disorder. Casliber (talk · contribs) 20:20, 5 April 2009 (UTC)

yes - thought disorder is more commonly only associated with serious mental illness, such as disorganised schizophrenia. Psychosis could be sufficiently explained in simply terms of delusions and hallucinations. Earlypsychosis (talk) 07:55, 6 April 2009 (UTC)

The fact is that thought disorder is a psychotic symptom, and one which may define any psychotic illness. It is not a delusion nor a hallucination. You may want to restrict psychosis to delusions and hallucinations but that would be original research. have you got some scholarly publication which does this? Casliber (talk · contribs) 08:04, 6 April 2009 (UTC)

So if I find one, then I can delete thought disorder? Earlypsychosis (talk) 08:18, 6 April 2009 (UTC)

Ahem (a) let's see what it is (i.e should be some form of review article or authortiative text) and (b) get a consensus. Casliber (talk · contribs) 10:15, 6 April 2009 (UTC)

If medical science and psychiatry include thought disorder as a form of psychosis, wiki editors shouldn't choose to present incomplete info just because it's a preference, easier, or to be like other websites. If peer review articles are found, they merit notation, not deletion of the section unless the symptom is officially no longer part of psychosis. —Preceding unsigned comment added by Kfcinca (talk • contribs) 01:59, 14 May 2009 (UTC)

No. Psychosis as used by the medical community denotes many abberant experiences that cannot be explained. Drugs, mental illnesses, sleep deprivation, sensory deprivation, loss of blood, increased ICP, basically anything altering the normal relationship between the thalamus and the cortexies. In my opinion, as defined by the DSM-IV, masturbation/orgasm is considered a form of psychosis. Catatonia, ataxia, thought disorder, delusions, its all there. — Preceding unsigned comment added by Guywholikesca2+ (talk • contribs) 08:12, 5 April 2012 (UTC)

Does anyone find this biased?

"However, increasing evidence in recent times has pointed to a possible dysfunction of the excitory neurotransmitter glutamate, in particular, with the activity of the NMDA receptor. This theory is reinforced by the fact that dissociative NMDA receptor antagonists such as ketamine, PCP and dextromethorphan/detrorphan (at large overdoses) induce a psychotic state more readily than dopinergic stimulants, even at "normal" recreational doses. The symptoms of dissociative intoxication are also considered to mirror the symptoms of schizophrenia more closely, including negative psychotic symptoms than amphetamine psychosis. Dissociative induced psychosis happens on a more reliable and predictable basis than amphetamine psychosis, which usually only occurs in cases of overdose, prolonged use or with sleep deprivation, which can independently produce psychosis. New antipsychotic drugs which act on glutamate and its receptors are currently undergoing clinical trials."

I suspect this is someone with a personal ax to grind against dissociative drugs. Specifically because it has no sources and it's written from an anti-drug perspective. As someone who has actually done research on this I've yet to find any scientific info claiming ketamine, PCP, or DXM cause psychosis —Preceding unsigned comment added by YVNP (talk • contribs) 10:01, 22 November 2009 (UTC)

I'm not an expert in this area, but a Google Scholar search for "ketamine-induced psychosis" turns up lots of references, including rather definitive things such as PMID 9167508. There are also reviews discussing this topic, for example PMID 17349858. Looie496 (talk) 17:02, 22 November 2009 (UTC)

I looked around too and it does seem there are mentions of dissociatives causing psychosis. The problem I have is it seems to be suggesting that the dissociative experience is basically the psychotic experience. The problem I have is that generally when someone hallucinates from dissociatives they are aware that there hallucinations are personal where as a psychotic patient usually wouldn't. YVNP (talk) 10:23, 23 November 2009 (UTC)

If that point can be referenced to a high-quality source (i.e., something like a review article in a top-level journal), it would probably be worth adding to the article. Looie496 (talk) 17:29, 23 November 2009 (UTC)

On erowid I found some articles discussing dissociatives. According to those articles dissociatives usually induce "closed eye visuals" and "detached" states of mind. I'll try adding them. YVNP (talk) 01:19, 24 November 2009 (UTC)

its fixed a bit. YNPV, i'd say NMDA antagonists with sigma receptor agonistsic capabilities are as close to (exo)chemically induced psychosis as we're gonna get. But they key difference between a schizophrenic's psychosis and a drug induced state is that a shizophrenic's brain is pretty normal, in terms of nuerotransmitter concentration and release from individual nuerons. Its the arrangement, how their brains have plasticisized from a combination of social isolation and extrememly strongly held delusional beilifs, which creates a permanent psychosis once it advances beyond a certian point. A dissasociative is reversible, once it's metabolized, ignoring the synaptic plasticity that occoured under the influence, you return to normal. — Preceding unsigned comment added by Guywholikesca2+ (talk • contribs) 08:20, 5 April 2012 (UTC)

Issues with the "Causes" section

I just made a lot of small changes to the quality of the writing in the "Causes" section - things like correcting bad grammar and style, and rewording so that every sentence makes sense and can be followed without difficulty. However, the style still seems idiosyncratic and the form/wording of many sentences could be improved. Additionally, this section could use a partial rewrite, or at least a close reading, by an expert in the subject. I say this mostly because the this section does not follow a clear organizational scheme, but I don't feel qualified to work on that because one might have to actually change the content and the points made in order to reorganize it, and I don't know enough about the subject to do that. Brad Gibbons (talk) 17:57, 19 May 2012 (UTC)

Subanesthetic dose

I just expanded "subanesthetic doses" to "subanesthetic doses (doses insufficient to induce anesthesia)".

I did this partly because the article was marked

and partly because I did not know what this meant myself before I looked it up.

I would rather have made "subanesthetic doses" into a wiki link and avoid the explanation in parentheses, but "subanesthetic doses" does not exist as an article.

Personally I would prefer to create a very short article called "Subanesthetic dose" with a very short explanation, something like "A subanesthetic dose is a dose of a pharmacological drug that is insufficient to induce anesthesia." But I feel there is a resistance of very short articles here on Wikipedia – I don't quite know why, because sometimes a subject can be explained very shortly and to the point. And in this case we could avoid an explanation in parentheses that is just annoying for people that know what "subanesthetic" means.

Would it be very bad to create a new article as suggested?

--Jhertel (talk) 14:43, 15 June 2012 (UTC)

It does seem rather like a dictionary entry than an article. But... I bet it could be expanded; why are such doses used? Are they common? Part of specific regimes? Pros, cons? Etc. Just a thought. This current article, btw, is actually a complete mess. lol I might get the urge to de-jargonize it some. Or not; who knows what edit lurks in the hearts of men?? Eaglizard (talk) 14:31, 17 June 2012 (UTC)

Grammar Issues

I'm fairly new to Wikipedia, but I think it's necessary to put this here and point out that the whole introductory section is FILLED with grammatical errors. Someone (with more knowledge than myself) needs to look into cleaning it up. Using the word "thus" three sentences in a row isn't professional or attractive. We can try to diversify our word usage. Speaking of word usage, did someone spend an hour with a thesaurus to write this thing. Half of the words here are completely out of touch with most users. I could call it gradiloquent, but I think it's for the best that we all just call it wordy and bring this back to the non-English/non-Psychology majors. We come to this page to be educated, not overwhelmed.

Thanks 76.108.101.22 (talk) 02:44, 19 June 2012 (UTC)

The lede is awful. By paragraph three it is deep into meaningless (to the lay reader) jargon, and as the above poster mentions, is full of grammatical errors. Someone both literate and familiar with the topic might be able to help. Sadly, the merely literate cannot decide what of this gibberish goes where and what it means, if anything.

This article, simply, lacks a clear lay language introduction, that, say, a high school or college student could easily understand. Huw Powell (talk) 05:18, 2 July 2012 (UTC)

Strong emotions can cause temporary psychosis/delusions/hallucinations

I strongly remember reading about very or extremely intense emotions causing temporary psychosis, in this article. I remember reading it in a list which also includes sleep deprivation. I found this letter one, but nothing about the emotion part. Actually I can't even find the section, just one for delusions. So was it removed or am I looking at the wrong article. Dqeswn (talk) 09:46, 11 July 2012 (UTC)

Psychoactive drugs section: THC

I removed an incomplete sentence, along with its two refs, which were also not properly formatted:

Older studies indicate that certain strains containing large proportions of tetrahydrocannabinol and low proportions of cannabidiol^[1]^[2]

Hopefully someone can finish this sentence and format the refs. It was not immediately obvious to me what the sentence would have been, based on looking through those two papers. Eflatmajor7th (talk) 20:52, 25 December 2012 (UTC)

Good that you saw this. However, usually, when sentences are cut in half, there is a version in the history of the page in which the sentence was complete. Instead of removing sentences, or start looking at the sources, it can be better to check history. With friendly regards! Lova Falk talk 07:52, 26 December 2012 (UTC)

Thanks for the advice, and the recent edits! I did a couple more things: I replaced a sentence to be more consistent with a reference, re-phrased the next sentence, and deleted two references, which I will put here. None of the references had to do with "strains" of cannabis as the deleted sentence suggested. One reference was a dead link, although I found the paper that was meant to be cited, below. The other deleted reference had nothing to do with the topic of THC versus CBD, also below. The findings of the reference I kept are now more accurately summarized in the article.

http://www.bmj.com/content/332/7534/172

and^[3] Eflatmajor7th (talk) 09:45, 27 December 2012 (UTC)

Good job! Lova Falk talk 09:57, 27 December 2012 (UTC)

dopamagenic causes missleading - incomplete

Just quickly The dsm lists anti depressants as a possible cause of schizoaffective disorder and atypical anti psychotics also lower seritonin. Cannabis or cannabaloids are know to have both psychosis causing, paranoia types and psychosis curing types. Ketamin which doesn't touch dopamine can cause psychosis that looks like schizophrenia Opiates touch dopamine but are a tradidional treatment for psychosis Studfies show myline and brain connectivity to be the biological cause of schizophrenia no dopamine changes seem to have ever been measured in humans dispute dopamine pathway and metabilite differences , lower dopamine, being widely cited in autism. Also autistics with apparently more efficient dopamine pathways can have all of the features of psychosis esp when comorbidity with depression. Dopamine is also used to treat depression, hallucinations are listed as a feature of depression in some screens. — Preceding unsigned comment added by 92.40.253.206 (talk) 11:54, 24 January 2013 (UTC)

Drug company propaganda in the intro

Starting with this:

"An excess in dopaminergic, and a deficit in glutaminergic (specifically NMDA) signalling correspond to positive and negative symptoms respectively."

Seriously, if the glutamate hypothesis had any validity, then wouldn't you think Eli Lilly hadn't terminated the development of a drug treatment based on that hypothesis due to constant failures to show efficacy over placebo? See: http://en.wikipedia.org/wiki/LY2140023

And if there were anything much to the dopamine hypothesis, then wouldn't antipsychotics, you know, actually succeed in treating positive symptoms instead of failing miserably as suggested by meta analyses after taking likely publication bias into consideration?

Sorry, these hypotheses are failures with nothing to support their continued popularity except fraud, confirmation bias, and gullibility. They're like the serotonin hypothesis of the cause of depression: zero scientific evidence of efficacy beyond placebo when you look past popular misconceptions and obvious deceit.

I'll be rewriting that part in the next couple of weeks unless someone provides me with evidence here that I'm not absolutely right. The rewrite will go something like this: There is a popular but erroneous belief that positive symptoms can be treated by targeting dopamine receptors. This is not so, as demonstrated in a 2009 meta analysis of published trials of second generation antipsychotics. Firrtree (talk) 19:15, 19 March 2013 (UTC)

P.S. Don't bother to revert my (future) revision without actual, real, solid, scientific evidence supporting your claims. I mean something that isn't just a couple of carefully picked studies "proving" whatever you want to prove. You'd need something to beat this:

A 2009 systematic review and meta-analysis of trials in people diagnosed with schizophrenia found that less than half (41%) showed any therapeutic response to an antipsychotic, compared to 24% on placebo, and that there was a decline in treatment response over time, and possibly a bias in which trial results were published.[11] In addition, a 2010 Cochrane Collaboration review of trials of Risperidone, one of the biggest selling antipsychotics and the first of the new generation to become available in generic form, found only marginal benefit compared with placebo and that, despite its widespread use, evidence remains limited, poorly reported and probably biased in favor of risperidone due to pharmaceutical company funding of trials.[12]

http://en.wikipedia.org/wiki/Antipsychotic#Efficacy

I rest my case. Firrtree (talk) 19:29, 19 March 2013 (UTC)

I would encourage you to clarify and make helpful additions to the lede. But I would also encourage you not to use language as strong as your example in your above post. The two studies you mentioned are no doubt important, and should be featured prominently in the article. But two meta-analyses do not justify calling traditional scientific dogma "erroneous", and do not justify the phrase "this is not so", which is kind of awkward for an encyclopedia article anyway. I think the WP article you linked is a good example of the way you should approach this re-structure, and the type of language you should use. Eflatmajor7th (talk) 22:37, 19 March 2013 (UTC)

Is there a Wiki rule that says Wikipedia should respect or adhere to "scientific dogma" even in cases where that dogma has turned out to be based on nothing but bias and what amounts to fraud? The dopamine hypothesis was always just that, a hypothesis. It was at best an unscientific dogma, but more likely tons of psychiatrists kept quite about their doubts simply to keep their jobs. If it's a dogma, it's a dogma that has meant the misallocation of thirty years of time, energy and the loss of billions of dollars, paid for by patients and tax payers. I think that fact merits the use of direct language. Of course, if someone wants to revise the lede before I do and does so with more restraint, I'm unlikely to complain about it. Firrtree (talk) 18:04, 20 March 2013 (UTC)

The relevant Wikipedia policy is WP:NPOV. You are giving the impression of having very strong views about this issue that will make it difficult for you to summarize the body of existing literature in a neutral way. Looie496 (talk) 18:14, 20 March 2013 (UTC)

All I'm doing is opposing badly aged dogma, and dogma is itself the definition of "very strong views". I'm the opposite of dogmatic, in this case as in many others, and have presented the best current evidence available on this topic to back my views, so it's rather ironic you'd accuse me of having "very strong views". If there were evidence against my views, I would revise them accordingly without feeling any threat to my self-identity or career or importance as a human being.

That means my views can't be "very strong" in any meaningful sense. I'm just angry that current practice and dogma are based on outdated information, confirmation bias, and wishful thinking. Essentially, I'm the Galileo here, not the other way around. Sorry, but if that sounds biased to you, you may need to recalibrate your viewpoint. This isn't the 1990s anymore. Science has moved on, thankfully. Firrtree (talk) 22:54, 21 March 2013 (UTC)

More evidence to support my views, from Mark Rich's freely available article, Another Look At Schizophrenia:

Metabolite tests provide an indirect way of measuring the amount of dopamine in an area of the brain. One, conducted in 1974 by Malcolm Bowers at Yale University found that the levels of dopamine metabolites in unmedicated schizophrenics were normal.

He published his findings in the 1974 issue of Archives of General Psychiatry, declaring that the results “do not furnish neurochemical evidence for an overarousal in these patients emanating from midbrain dopamine system.”

Then, in 1975 Robert Post at the NIMH, reported in the Archives of General Psychiatry, in an article entitled, Cerebrospinal Fluid Amine Metabolites in Acute Schizophrenia, that no evidence of elevated dopamine levels had been found in 20 unmedicated patients diagnosed with schizophrenia, compared to healthy controls.

Because the researchers could not determine that schizophrenics had an abnormal amount of dopamine, they decided to try to prove that the postsynaptic neurons had too many receptors. In 1978, studies conducted at the University of Toronto revealed that the brains of schizophrenics had about 50% more dopamine receptors than healthy controls.

However, all of these patients had been on neuroleptics, which, as the researchers even suggested, possibly caused the abnormality. Future studies conducted on animals revealed that this was in fact the case. The tests that showed an excessive amount of dopamine neurotransmitters were done on patients that had been receiving neuroleptics. The increase has been attributed to a normal brain adapting to the medication.

Drs. Peter R. Breggin, MD, and David Cohen, PhD, described the dopamine theory as “pure guesswork” from organized psychiatry. In a 1982 issue of Schizophrenia Bulletin, in an article named The Dopamine Hypothesis, UCLA neuroscientist John Haracz concluded: “Direct support [for the dopamine hypothesis] is either uncompelling or has not been widely replicated.”

The 1974 study by Bowers at Yale University revealed that after people had been medicated, a significant increase in dopamine levels occurred. This was evidence of a normal brain’s reaction of creating more dopamine after its signals had been artificially blocked by medication. Other studies soon reported similar findings.

An article published by German researchers entitled, H-Siperone Binding Sites in Post-Mortem Brains from Schizophrenic Patients, that appeared in the 1989 issue of Journal of Neuronal Transmission declared, “From our data ... we conclude that changes in [receptor density] values in schizophrenics are entirely iatrogenic [drug induced].”

Firrtree (talk) 18:09, 22 March 2013 (UTC)

I am going to undo your recent change and put your paragraphs here instead, so we can work on them. I will list some ideas about how it could be better. Eflatmajor7th (talk) 22:18, 22 March 2013 (UTC)

An excess in dopaminergic, and a deficit in glutaminergic (specifically NMDA) signalling are traditionally thought to correspond to positive and negative symptoms respectively, although recent meta analyses of drug trials provide little evidence to support the dopamine hypothesis^[4]^[5], and drug trials based on the glutamate hypothesis have failed to demonstrate efficacy.^[6]

The NMDA antagonist MK-801 is used in animal models of schizophrenia,^[7] while paranoia and delusional thinking are moderately to lowly associated with heavy methamphetamine users.^[8]^[9] In those with an organic psychosis, a complex cluster of genetic and environmental factors are involved in the creation of the endogenous imbalance of neurotransmitters observed in those with psychosis.^{[citation needed]}

First, an encyclopedia shouldn't mention "recent" events, and their recentness shouldn't be taken as evidence that they are right. See for instance WP:RECENTISM. I would advise against referring to "the dopamine hypothesis", especially in the lead; instead, just briefly describe what that is supposed to mean, and how it differs from some available data. Later in the article "the dopamine hypothesis" is referred to along with an internal WP link, but I glanced at that article and it's pretty messy, I'd prefer not to link to it until we make it better. I think all citations in the lead of a fairly prominent article should be articles in peer-reviewed journals, and they should all be properly formatted; none of yours were. You can use the Templates --> Cite journal. I'm sure you also realized that one of your references was a dead link. I don't know why you separated off the second half of the paragraph. And as long as you're working on it, maybe you could fill in the references in this paragraph to be fully formatted? And/or find a citation for the CN? Hope this will be helpful. Eflatmajor7th (talk) 22:50, 22 March 2013 (UTC)

So I'll replace "recent" with "first" or "first notable" or "first extensive". The reason old data on antipsychotics are misleading is that there has been a lot of bias in terms of which trials have been widely publicized. These meta analyses are basically the first somewhat honest estimates of the efficacy of these drugs.

Once again, what matters is facts and evidence, not drug company propaganda, so it's completely irrelevant what kind of grand history antipsychotics appear to have in terms of single studies you can dig up that, considered alone, seem to prove efficacy. What matters is which results you can trust. Obviously, you can trust these meta analyses much more than some two or three lucky flukes that have been publicized to death in textbooks and corporate sponsored lectures and info gatherings.

Yes, there does appear to be one broken link. I was simply copying that citation from the other Wiki page. I will try to hunt down the article tomorrow.

Here's a new version of those two paragraphs, which I'll put into the intro if there's no serious criticism of them here:

An excess in dopaminergic signalling is traditionally thought to correspond to positive symptoms, although recent meta analyses of drug trials provide little evidence of such a mechanism^[10]^[11].

As I said, I'll try to fix that link later. The other link links to Nature, so I'd say it's a "peer reviewed" article. You'll notice I deleted the other paragraph, as well as the stuff about the glutamate hypothesis. I don't think they should be included in the intro. Here's why: the glutamate hypothesis isn't a well established theory, and what few human experiments there have been, have failed to demonstrate efficacy when considered as a whole. Editors can ramble on about it elsewhere in the article, of course. Makes sense, right? IMO, the same goes for organic causes of psychosis: little, basically nothing, is known about the topic, so why not just avoid it? Let's take hypothyroidism as an example: rarely associated with psychotic symptoms. This is the fact, even though it has a reputation as one of the causes of schizophrenia like symptoms. Also, that particular passage about organic causes in the intro didn't include a citation anyway and just sounded stupid in general. I mean, "they are caused by a combination of genes and environment." Well, duh! What isn't?? You're welcome to add that crap elsewhere in the article, but I personally think it's embarrassing in the intro. The methamphethamine stuff is also stupid. I already corrected the idiotic "typical" to "moderately to lowly associated with". Doesn't really belong to the intro in that form, because it's obvious nobody knows the mechanism behind such psychotic symptoms, and there aren't many serious studies about meth use and psychosis anyway.

I expect NOT to get reverted again, without solid, weighty criticism. If you think you can write it better, please do so, but don't revert back to the ridiculous rubbish that is the current latter part of the intro. That said, I'll give you a day or so to make the necessary changes yourself, or come up with something of substance to contribute, while I try to hunt down the missing article. Firrtree (talk) 04:07, 24 March 2013 (UTC)

I know Nature is peer reviewed. Just please try to format the refs correctly, with the Cite Journal template. This includes authors, volume and issue numbers, page numbers, etc. Eflatmajor7th (talk) 04:52, 24 March 2013 (UTC)

I don't know how to do it. I just copied the way other people used references in the passage I edited and in the paragraph in the other article from which I DIRECTLY COPIED two references from. If there's a problem with those references, then it's a problem that has been there for a long time and isn't primarily my problem. I welcome you to improve my references, of course. But it's a bit pompous to tell me to do everything perfectly and on my own, as if the quality of these articles were solely my responsibility. Anyway, here's a working link to the Cochrane meta analysis of Risperidone: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2879694/

Firrtree (talk) 15:35, 24 March 2013 (UTC)

That's mostly a good edit as far as I'm concerned, thanks, although I must point out that the last bit seems rather comical. You are essentially saying that although the dopamine hypothesis is apparently incorrect, the whole psychiatric community and society at large weren't deluded for decades, we merely haven't found the COMPLETE TRUTH yet — "more complexity" needed as opposed to a new paradigm, you say. Which I think is absurd but have it your way. Firrtree (talk) 19:43, 24 March 2013 (UTC)

Alcohol Induced Psychosis Case Study

I use case study lightly because this is just the alcoholic self reporting... BUT... AIP is just withdrawal from a higher BAC. I have been through withdrawal many times and it is something that happens when you have been at .2 bac for too long. AIP is something that happens when you have been at .4 bac for too long and sober up too quickly. You can be over .2 withdrawal and get back to normal sleeping patterns and still hear voices from your .4 BAC withdrawal. Guess what the solution is? Get plastered (.4 bac) again for one night (avoiding .2 bac withdrawal) and have more time to come down off of that BAC level. A 750 ml bottle of liqour did it for me after I had auditory hallucinations. The first one made the voices much quieter, the second one made the voices disappear. Not a study so it can't be on the page, but the page's info is BS Alcohol Induced Psychosis is not a long term effect of alcoholism it is a separate version of withdrawal that happens from having high levels of BAC for too long.

Now no matter how hard I listen... No voices!!!

Interesting, but personal stories are not appropriate for this page. Wikipedia talk pages should only be used to discuss improvements to the article, and any changes to the article need to be based on reputable published sources. Looie496 (talk) 16:49, 26 March 2013 (UTC)

Incoherence in the "neurobiology" section.

If you read the entirety of the neurobiology section, you will observe, as I did, several sentences that make no grammatical sense and whose intent is obscured by the fact of incoherency. — Preceding unsigned comment added by 108.215.108.72 (talk) 17:08, 12 April 2013 (UTC)

Example: last paragraph in this section reads,

In a schizophrenic's brain, an independent circuit within the entorhinal cortex/basal ganglic complex has formed. Through layer III/I transmission to the greater area of the medial temporal lobe. This then results in the auditory hallucinations observed in schizophrenia.[83] The specific mechanisms of LTP are unknown at the moment, but NMDA receptors crucial for the burst firing required, and dopamine plays a very important role in medating basal ganglic, thus hippocampal and memory activity(which is much more complex, involving neurogenesis and LTD as well). Thus, the neurochemical alterations which induce psychosis in otherwise healthy people are indicative that the root of the symptoms altered thalamocortical and hippocamalcortical transmission, and corresponding layer 5/thalamus axis function, altering the crucial ordered cortiocortical layer 3/1 and 2/3 transmission necessary for rational language self-expression.

Can anyone make sense of this? It seems to have been written by someone experiencing schizophrenia perhaps. In any case, the thoughts are disjoint, or expressed so poorly that they are incoherent. I don't know enough about the subject matter to fix it, but I do notice that no one can understand this. — Preceding unsigned comment added by 108.215.108.72 (talk) 17:12, 12 April 2013 (UTC)

You're right, it doesn't make sense, and doesn't even appear to be trying to make a coherent point. Also none of this material is in the source provided. I'm going to just delete the paragraph, and maybe we should consider merging the remainder of the "Neurobiology" subsection into the main "Pathophysiology" section. Eflatmajor7th (talk) 00:18, 13 April 2013 (UTC)

I've removed some more from that section. All that stuff was added about a year ago by Guywholikesca2+ (talk · contribs). It does make contact with scientific research, but it's incoherently written, full of errors, and unsourced, so I don't think it belong here. Looie496 (talk) 02:32, 13 April 2013 (UTC)

Treatment History

As a part of a senior research project, our university requires that students make historically relevant contributions to a Wiki article. The treatment of psychosis has a rich history that would likely be of interest to readers. These include shock therapies and the advent of dopamine antagonist (both generations). Does anyone have any suggestions? Thank you, -Jesse — Preceding unsigned comment added by Jbv264 (talk • contribs) 18:03, 11 November 2013 (UTC)

Beautiful job on improving this article guys!

It is in much better condition than it was at the end of October! Very nice work. Nice to see the mind-body problem reduced to materialism as it should be. There are still too many docs (myself not included) that think psychiatry is functional vs organic (the rest of medicine). Nothing could be further from the truth. Functional causes haven't yet been figured out. Nice job to all of you!Youtalkfunny (talk) 21:16, 2 December 2013 (UTC)

PS:

Keep it up!Youtalkfunny (talk) 21:17, 2 December 2013 (UTC)

"Illicit substances"

I have no qualifications to edit this page, but I'm wondering about the line: "Medical and biological laboratory tests should exclude central nervous system diseases and injuries, diseases and injuries of other organs, illicit substances ...". This suggests that the thing which causes a substance to produce psychosis-like symptoms is legislators passing a law against it. Shouldn't a word like "psychoactive" be used, rather than "illicit"? — Preceding unsigned comment added by 124.178.123.4 (talk) 14:59, 19 April 2014 (UTC)

Hi 124.178.123.4! Good reading! You are quite right, and I'll change it according to your suggestion. Next time, please be bold and make the edit yourself.

With friendly regards, Lova Falk talk 09:42, 14 May 2014 (UTC)

Fixed

Topics from 2003

Topics from 2004

Psychotic experience

An anon user deleted the following:

Although usually distressing and regarded as an illness process, some people who experience psychosis find beneficial aspects and value the experience or revelations that stem from it.

I have not personally heard of anyone saying this but someone has added this to the article and I believe that should be respected and thus reinstated. How does everyone else feel about this? --CloudSurfer 03:18, 20 Oct 2004 (UTC)

Hi CloudSurfer,

I've reinstated it, as it is plainly clear from the work of people like R. D. Laing and others (whatever you think of his theories) that some people do find beneficial aspects to psychosis. I've personally met many patients who found insights they gained from the experiences were positive, even if the majority of their psychotic experience was distressing or impairing. - 131.251.37.132 07:13, 20 Oct 2004 (UTC)

Topics from 2005

Topics from 2006

Topics from 2007

Dreams and Psychosis

I am reading a book on the relationship between states of dreaming consciousness and psychosis by J. Allan Hobson called The Dream Drugstore. I realize it's not a journal, however I also feel like he makes some interesting parallels that are backed up by observation. Would it be alright to add a section or is it too fringe or covered somewhere else? I'd hate to mess up an FA. Thanks, LilDice 19:15, 25 January 2007

Topics from 2008

Topics from 2009

Topics from 2012

Topics from 2013

2014

Tab stop

Too many edits have made this page disorganized IMO. There are two "treatment" headings , one current, one of historical. The text needs a "tab stop" to orient the reader https://en.wikipedia.org/wiki/Tab_stop .--Mark v1.0 (talk) 20:49, 28 September 2014 (UTC)

Making Wikipedia more accessible

The information on this and many other pages is very extensive and may be hard to read for many who may want to get the information. How about adding a link to youtube with a screen view of a Text to speech reader reading the text? — Preceding unsigned comment added by Ex-nimh-researcher (talk • contribs) 19:55, 1 October 2014 (UTC)

Addition

This article from the edit by the IP is a recent review [2] The rest of the sources are not good. I guess the next question is how should we summarize it. Doc James (talk · contribs · email) (if I write on your page reply on mine) 21:27, 1 October 2014 (UTC)

Belongs on Schizophrenia, if it is to be used at all. Yobol (talk) 22:06, 1 October 2014 (UTC)

Already their :-) Agree Yobol. Doc James (talk · contribs · email) (if I write on your page reply on mine) 22:26, 1 October 2014 (UTC)

Biased Editing in Psychosis Article

I just read an article from the Mad in America website saying that the author is rewriting the psychosis article to basically fit his opinions and perceptions of psychosis. He is describing to others how they may do the same while flying under Wikipedia's radar.

I normally don't write anything on Wikipedia, but I know that bias and personal opinion is generally not tolerated, and I wanted to inform the staff. — Preceding unsigned comment added by 108.198.225.14 (talk) 23:31, 27 September 2014 (UTC)

I am the user with one of these edits. They are based on very reputable articles e.g. from Schizophrenia Bulletin. There is no reason to think this is POV. Wikipedia should include information like this even it may be against the commercial pharma view. I am a clinician and I see with sadness how antipsychotics really may destroy for young people. — Preceding unsigned comment added by Ex-nimh-researcher (talk • contribs) 19:45, 1 October 2014 (UTC)

This was undone again by jmh649 without justification here. Since it was not justified, I will change it back. — Preceding unsigned comment added by Ex-nimh-researcher (talk • contribs) 21:38, 1 October 2014 (UTC)

These sources do not appear to be compliant with WP:MEDRS policies. For example, there is a very strong preference on Wikipedia for secondary sources such as review articles rather than primary longitudinal studies. TylerDurden8823 (talk) 21:51, 1 October 2014 (UTC)

Are you seriously claiming that Schizophrenia Bulletin is not a valid source? I don't think many of the references in this article come from more reputable sources. How about this one:^ Chan-Ob, T.; V. Boonyanaruthee (September 1999). "Meditation in association with psychosis". Journal of the Medical Association of Thailand 82 (9): 925–930. PMID 10561951.

This ref is good. [3] The thing is that it is about schizophrenia rather than psychosis. Other refs are primary sources. It is already used on the schizophrenia article. Doc James (talk · contribs ·

email) (if I write on your page reply on mine) 22:30, 1 October 2014 (UTC)

This is a case report [4] not an appropriate source. Doc James (talk · contribs · email) (if I write on your page reply on mine) 22:33, 1 October 2014 (UTC)

Let's not put words in my mouth. I never said Schizophrenia Bulletin is not a valid or reputable source. What I specifically said is that the articles chosen do not conform to WP:MEDRS criteria (e.g., they're not review articles and are primary longitudinal studies (see above)). I do see that Schizophrenia Bulletin is a reputable peer-reviewed medical journal and have no issue with the source itself. However, it appears that you are right about some of these and some are indeed review articles such as this one (http://schizophreniabulletin.oxfordjournals.org/content/early/2013/03/19/schbul.sbt034.full.pdf). Additionally, not all of the material you restored is from Schizophrenia Bulletin. I saw other journals mentioned. I will need to take a closer look to see which ones are secondary sources and which are not. I can also sense in your response that you seem upset and I don't want you to think any of this is personal, we simply need to discuss the addition of this material. That's all there is to it. If we find sources discussing this information that meet WP:MEDRS criteria, I have no objection to their inclusion in the article. As for the source from 1999, I will have a look, but we usually prefer updated reviews and. in the world of psychiatry, a lot can change in 15 years. TylerDurden8823 (talk) 22:49, 1 October 2014 (UTC)

Exactly. So we need to use 1) secondary sources 2) use sources that pertain to psychosis Doc James (talk · contribs · email) (if I write on your page reply on mine) 22:55, 1 October 2014 (UTC)

The journals are fine and after taking a closer look the following appear to be secondary sources from the attempted edits:

1. http://schizophreniabulletin.oxfordjournals.org/content/early/2013/03/19/schbul.sbt034.full.pdf

However, the following sources from the attempted edits appear to be primary in nature:

In the future, when citing these publications, it's also best to use the cite journal format as seen on various medical articles and include their URL, PMID (if applicable), etc. so that they're easier to find and access. I would have no objection to including material from the secondary source above from Schizophrenia Bulletin, but the longitudinal studies (even if 15-20 years in duration) remain primary sources and are not ideal for use on Wikipedia per WP:MEDRS (which I advise reading at your earliest convenience since it explains a lot of our discussion points in more depth). TylerDurden8823 (talk) 23:05, 1 October 2014 (UTC)

Protected

The article has been full-protected for a few days due to the ongoing multi-party editing dispute. Please work out your differences regarding the content on the Talk page and come to a consensus. Thanks... Zad68 22:36, 1 October 2014 (UTC)

I have investigated this a bit more closely and I have upped the full-protection to a full week due to concerns about canvassing/meat-puppetry. Please use this time to familiarize yourself with Wikipedia content and behavior rules, and work collaboratively to build consensus for content change suggestions. Suggestions that have a firm consensus here on the Talk page may of course be implemented before the full protection expires. Zad68 02:08, 2 October 2014 (UTC)

So sorry about this overzealous behavior on my part. It was based on ignorance. I have read the talk page on psychosis and understand the respectful tone there. I will inform the MIA readers of this and always go for consensus. Ex-nimh-researcher (talk) 07:58, 3 October 2014 (UTC)

How about adding a subsection “controversy” , controversy over treatment of psychosis or something like that ?

2.150.25.23 (talk) 10:47, 4 October 2014 (UTC)

First thing we need is some high quality secondary sources that discuss the issue and then we can discuss. Doc James (talk · contribs · email) (if I write on your page reply on mine) 14:47, 4 October 2014 (UTC)

The lede contains the sentence:

"Many antipsychotic drugs accordingly target the dopamine system; however, meta-analyses of placebo-controlled trials of these drugs show either no significant difference in effects between drug and placebo, or a moderate effect size, suggesting that the pathophysiology of psychosis is much more complex than an overactive dopamine system.[8][9]"

I don't think anyone will dispute the obvious sentence "the pathophysiology of psychosis is much more complex than an overactive dopamine system", but the rest of this sentence represents cherry picking and WP:OR.

NICE recommends antipsychotics as first line therapy for schizophrenia, stating on the basis of an extensive sytematic review:

"For people with first episode psychosis offer: oral antipsychotic medication (see sections 1.3.5 and 1.3.6) in conjunction with psychological interventions... Advise people who want to try psychological interventions alone that these are more effective when delivered in conjunction with antipsychotic medication.(http://www.nice.org.uk/guidance/cg178/chapter/1-recommendations")

They are a first line treatment recommendation by the British Association for Pharmacology, which says they are "effective" . http://www.bap.org.uk/pdfs/Schizophrenia_Consensus_Guideline_Document.pdf

The Cochrane group has reviewed many of these drugs. Recent meta analyses stated:

"Our results agree with existing evidence that compared to placebo, trifluoperazine is an effective antipsychotic for people with schizophrenia."(https://www.ncbi.nlm.nih.gov/pubmed/24414883)

"Chlorpromazine, in common use for half a century, is a well-established but imperfect treatment."(https://www.ncbi.nlm.nih.gov/pubmed/24395698)

"Haloperidol is a potent antipsychotic drug but has a high propensity to cause adverse effects. Where there is no treatment option, use of haloperidol to counter the damaging and potentially dangerous consequences of untreated schizophrenia is justified." (https://www.ncbi.nlm.nih.gov/pubmed/24242360)

The NIMH states that upon treatment with antipsychotics, "Symptoms of schizophrenia, such as feeling agitated and having hallucinations, usually go away within days. Symptoms like delusions usually go away within a few weeks. After about six weeks, many people will see a lot of improvement."http://www.nimh.nih.gov/health/publications/schizophrenia/index.shtml"

There are in fact very few meta analyses that show "no significant difference in effects between drug and placebo", and those that do refer mostly refer to specific drugs, not to antipsychotics as a group. Clearly these drugs are far from optimal in terms of efficacy and side effects. But any statement to the effect that they have "no significant effects" is a minority position at best, and fringe at the worst. We certainly should not have this one sided comment presenting the minority viewpoint in the lede. Formerly 98 (talk) 21:18, 8 October 2014 (UTC)

Delusion Addition

I added another example of delusions so that people reading this page can associate delusions with more than just depression and read more about other, more unusual delusions on other Wikipedia pages, as I personally think that associations are one of the most important ways for people studying psychology to remember important information. Delusions are also most commonly confused with hallucinations, so having a link to a delusion that commonly is confused with another symptom of psychosis would be helpful for users in differentiating the two.

Delusions

Psychosis may involve delusional beliefs, some of which are paranoid in nature. Put simply, delusions are false beliefs that a person holds on to, without adequate evidence. It can be difficult to change the belief, even with evidence to the contrary. Common themes of delusions are persecutory (person believes that others are out to harm him/her), grandiose (person believing that he or she has special powers or skills), etc. Persons with Ekbom syndrome may have delusional beliefs of an imaginary parasite infestation, ^[12] whereas depressed persons might have delusions consistent with their low mood (e.g., delusions that they have sinned, or have contracted serious illness, etc.). Karl Jaspers has classified psychotic delusions into primary and secondary types. Primary delusions are defined as arising suddenly and not being comprehensible in terms of normal mental processes, whereas secondary delusions are typically understood as being influenced by the person's background or current situation (e.g., ethnicity; also religious, superstitious, or political beliefs).^[13]

Thanks for joining us here. Do you have access to more recent and more comprehensive sources? The Wikipedia content guideline on reliable sources for medical articles is especially helpful for finding sources for an article like this. I keep a source list including psychology reference books in user space for you and other Wikipedians to use, and I invite you to follow the link. -- WeijiBaikeBianji (talk, how I edit) 01:04, 20 April 2015 (UTC)

Subtypes Issue - Cycloid and others

Cycloid psychosis is acknowledged in the literature but it not recognized in ICD10 or DSM 5. There is 'Brief psychotic disorder' which is considered similar.

Regardless, it seems a too rare and not universally agreed diagnosis to merit a complete description in the main psychosis article. I suggest it be moved to the article "Brief psychotic disorder".

Also, "Occupational psychosis" is apparently not actually a diagnosis as such and its own article has some problems. — Preceding unsigned comment added by Timetraveler3.14 (talk • contribs) 20:44, 18 August 2015 (UTC)

Van Gogh

Not sure what this has to do with psychosis? Doc James (talk · contribs · email) 10:41, 15 January 2016 (UTC)

I added the art image. What could represent a visual image representation of psychosis? ( that would meet your satisfaction?) Van Gogh reportedly had mental illness or a physical illness that altered his sense of sight, and his art is believed to an expression of what he saw (psychosis).--Mark v1.0 (talk) 21:52, 23 January 2016 (UTC).

I am wanting a reference that this imagine is a representation of psychosis. Doc James (talk · contribs · email) 22:13, 23 January 2016 (UTC)

Okay found a ref. Doc James (talk · contribs · email) 22:23, 23 January 2016 (UTC)

i am probant

psychotic person have high abstract intelligence structurs — Preceding unsigned comment added by 80.157.80.122 (talk) 12:45, 21 April 2016 (UTC)

TODO: quit forwarding "frank psychosis" to this page or include an entry in this page for "frank psychosis." 107.214.236.216 (talk) 18:39, 16 September 2016 (UTC)

talk of forced treatment?

What about some talk about the prevalence of non-consensual psychiatry when treating those labeled as psychotic? Michael Ten (talk) 05:35, 8 January 2017 (UTC)

Reliable sources? It is of course done fairly routinely. Decreases the risk of the person hurting themselves or others. Doc James (talk · contribs · email) 08:20, 8 January 2017 (UTC)

van gogh's picture unrelated

The painting seems unrelated. The caption doesn't seem like good reasoning for it being there. User:Tiptup300 15:22, 19 July 2017 (UTC)

Did you read the ref[5]? Doc James (talk · contribs · email) 17:53, 19 July 2017 (UTC)

The ref[6] provides no evidence or sources for this claim. This obviously is an issue, since the author did not have first-hand access to Vincent Van Gogh's mental state in 1899. If you read the meticulously researched 2011 biography "Van Gogh: The Life" by Steven Naifeh and Gregory White Smith, you will learn that while indeed Van Gogh was indeed in the hospital while painting Starry Night, he was certainly not, as Ref1 and the caption asserts, in a psychotic state. Van Gogh planned this painting, like most of his others, in advance, writing letters about it to his brother Theo Van Gogh (you can find references to this in Naifeh and White Smith's book as well as by searching this catalogue of Van Gogh's letters: http://vangoghletters.org/vg/), and even composing an ink sketch plan of the painting before executing it, which you can view both in the book and here: https://en.wikipedia.org/wiki/File:Van_Gogh_Starry_Night_Drawing.jpg. When Van Gogh suffered what many medical experts now believe to be epileptic fits and their aftermath, he was not productive, and was barely able to function. He was only able to paint when he was lucid and well.

This falsehood about "Starry Night" perpetuates the dangerous myth that madness breeds creativity, and it is also damaging to the reputation of one of the most influential painters in the history of Western art, who again, would not have been able to create what is today considered one of his finest works if he were in a state of psychosis at the time of it's execution. Igiveaspirinheadaches (talk) 15:21, 27 January 2018 (UTC)

Ref says "While in a psychotic state in 1889 he painted starry night"[7]

It does not perpetuate that "madness breeds creativity" but supports just because someone has a mental illness does not mean that they are worthless.

Someone had diagnosed him with "epilepsy" at the time but it is currently much closer to the modern conception of psychosis.[8] Doc James (talk · contribs · email) 07:58, 27 January 2018 (UTC)

This is a decent source.[9] Doc James (talk · contribs · email) 08:11, 27 January 2018 (UTC)

The Ref is incorrect. Vincent van Gogh was NOT in a psychotic state when he painted Starry Night; he was hospitalized for a psychotic break, but he was lucid when he painted Starry Night. As stated above and linked to evidence, he planned the painting in advance, wrote letters to his brother Theo van Gogh about it, and then painted it. The 2005 source you cited is dated -- as I said, the 2011 biography of Van Gogh is considered the most well-researched and up-to-date source on his life; the other source cited still does state that Van Gogh was in a state of psychosis when he painted "Starry Night". Here is the page where the 2011 authors begin to write about Van Gogh's process during the time he painted Starry Night: https://books.google.com/books?id=HcYE8mZxDhoC&lpg=PP1&dq=van%20gogh%202011%20naifeh&pg=PA760#v=snippet&q=starry%20night%20saint-r%C3%A9my&f=false

Laypeople tend to use Van Gogh as a symbol of “look what a tortured mind can produce; mental illness is integral to great art,” when that’s a harmful trope, and he produced his great works when he was lucid. No one is saying that people with a mental illness are worthless, but it is entirely untrue that Van Gogh painted Starry Night while in a state of psychosis.

There is also a discussion about this on Twitter:https://twitter.com/sociolinguista/status/954589652530450432

The people who have chimed in on the discussion have understood why this is an issue. Two people on this talk page have raised this as an issue. There are very real concerns with the use of this painting as a representation of a psychotic experience, and they should not be ignored. Igiveaspirinheadaches (talk) 15:21, 27 January 2018 (UTC)

Your WP:OR does not constitute a sufficient reason to remove the image, as it contradicts a number of legitimate sources added here by Doc James. The fact that you fail to indent, along with the blatant OR and citing of a twitter discussion makes me think you have not read any of wikipedias policies. You should really read WP:OR, WP:INDENT, WP:PRIMARY, WP:MEDRS, WP:TUTORIAL.Petergstrom (talk) 21:24, 27 January 2018 (UTC)

Oh and don't forget WP:WAR, WP:3RR.Petergstrom (talk) 21:25, 27 January 2018 (UTC)

Regarding the twitter ~~discussion~~ rant, you should probably avoid saying "There is also a discussion", and instead say "I tweeted about this". Petergstrom (talk) 21:33, 27 January 2018 (UTC)

Poor Sourcing

Studies with sensory deprivation have shown that the brain is dependent on signals from the outer world to function properly. If the spontaneous activity in the brain is not counterbalanced with information from the senses, loss from reality and psychosis may occur after some hours. A similar phenomenon is paranoia in the elderly, when poor eyesight, hearing and memory make the person abnormally suspicious of the environment.

On the other hand, loss from reality may also occur if the spontaneous cortical activity is increased so that it is no longer counterbalanced with information from the senses. The 5-HT2A receptor seems to be important for this, since psychedelic drugs that activate them produce hallucinations.

However, the main feature of psychosis is not hallucinations, but the inability to distinguish between internal and external stimuli. Close relatives to psychotic patients may hear voices, but since they are aware that they are unreal they can ignore them, so that the hallucinations do not affect their reality perception. Hence they are not considered psychotic.

Increased level of right hemisphere activation has also been found in people who have high levels of paranormal beliefs^[14] and in people who report mystical experiences.^[15] It also seems that people who are more creative are also more likely to show a similar pattern of brain activation.^[16] 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 and others distressing. One research study has shown that the majority of people who hear voices are not in need of psychiatric help.^[17] The Hearing Voices Movement has subsequently been created to support voice hearers, regardless of whether they are considered to have a mental disorder or not.

Sensory deprivation and sensory impairment
Caffeine intoxication
An extremely stressful event

Leaving this here as per WP:PRESERVE.Petergstrom (talk) 22:01, 27 January 2018 (UTC)

References

^ THC and Psychosis from Neuropsychopharmacology 35, 764–774, dated 1 February 2010.
^ Cannabis and Psychosis from the British Medical Journal, dated 8 July 2005.
^ Degenhardt L (2003). "The link between cannabis use and psychosis: furthering the debate". Psychological Medicine. 33 (1): 3–6. doi:10.1017/S0033291702007080. PMID 12537030. {{cite journal}}: Unknown parameter |month= ignored (help)
^ How effective are second-generation antipsychotic drugs? A meta-analysis of placebo-controlled trials (2009). Nature.com.
^ versus placebo for schizophrenia. Cochrane Database of Systematic (2010)^{[dead link]}. Nelm.nhs.uk.
^ Strike three: Bad data bury Eli Lilly's late-stage schizophrenia drug
^ http://www.ncbi.nlm.nih.gov/pubmed/16517016
^ http://www.ncbi.nlm.nih.gov/pubmed/19097704
^ http://www.smh.com.au/national/health/ice-users-likely-to-suffer-psychosis-on-drug-study-finds-20130109-2cgr7.html
^ How effective are second-generation antipsychotic drugs? A meta-analysis of placebo-controlled trials (2009). Nature.com.
^ versus placebo for schizophrenia. Cochrane Database of Systematic (2010)^{[dead link]}. Nelm.nhs.uk.
^ Cahalan, Susannah. Brain on Fire-My Month of Madness, New York: Simon & Schuster, 2013.
^ Jaspers, Karl (1997-11-27) [1963]. Allgemeine Psychopathologie (General Psychopathology). Translated by J. Hoenig & M.W. Hamilton from German (Reprint ed.). Baltimore, Maryland: Johns Hopkins University Press. ISBN 0-8018-5775-9.
^ Pizaagalli, D.; Lehmann D.; Gianotti L.; Koenig T.; Tanaka H.; Wackermann J.; Brugger P. (2000). "Brain electric correlates of strong belief in paranormal phenomena: intracerebral EEG source and regional Omega complexity analyses". Psychiatry Research. 100 (3): 139–154. doi:10.1016/S0925-4927(00)00070-6. PMID 11120441.
^ Makarec, K.; Persinger M.A. (1985). "Temporal lobe signs: electroencephalographic validity and enhanced scores in special populations". Perceptual and Motor Skills. 60 (3): 831–42. doi:10.2466/pms.1985.60.3.831. PMID 3927256.
^ Weinstein, S; Graves R.E. (2002). "Are creativity and schizotypy products of a right hemisphere bias?". Brain and Cognition. 49 (1): 138–51. doi:10.1006/brcg.2001.1493. PMID 12027399. Retrieved 2006-08-19.
^ Honig A., Romme M.A., Ensink B.J., Escher S.D., Pennings M.H., deVries M.W.; Romme; Ensink; Escher; Pennings; Devries (October 1998). "Auditory hallucinations: a comparison between patients and nonpatients". J Nerv Ment Dis. 186 (10): 646–51. doi:10.1097/00005053-199810000-00009. PMID 9788642.{{cite journal}}: CS1 maint: multiple names: authors list (link)

Treatment text isn’t neutral and makes drugs seem more useful than they are

I have psychosis sickness so I am really worried about that article as it gives picture about psychosis that doesn’t fit well with the things I have seen in hospitals as patient among patients and it lacks completely evidence about problems with drugs.

”There is a good response in 40–50%, a partial response in 30–40%, and treatment resistance (failure of symptoms to respond satisfactorily after six weeks to two or three different antipsychotics) in 20% of people.[111]”

That makes it look like antipsychotics are really effective and helpful, but in those numbers they have not removed those ones that would have gotten better with just placebo treatment. https://www.ncbi.nlm.nih.gov/pubmed/18180760 has calculated Number Needed to Treat for antipsychotics. It is 6 meaning that you have to treat 6 people to get one that drug helps. Everyone else still gets those side-effects which I think that article really makes them feel nicer than they actually are. Remember those old classic movies about slow empty eyed people making baskets? That functioning problem still exists with newer antipsychotics.

Once treatment is started it is really hard to get off it without psychosis and many are kept with medication just in case or because lowering dose causes problems. That is called Maintenance Treatment and some new studies have found that it usually hinders long term recovery from psychosis. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4524699/ There is even Mad In America movement https://www.madinamerica.com that tries to educate health care professionals and patients how to taper off medicine safely to live healthier life and not to use them as the first-line treatment.

The one thing that also worries me about that article is that it lacks psychological explanations for psychosis making it sound like it is mainly biological state. Trauma is mentioned as one reason for psychosis, but that’s just about it. Article contains long explanations about findings what areas of brain have non typical behavior, but to understand why they happen, one has to understand a life of psychotic patients and what they are going trough inside their heads.

In the most cases problem isn’t in chemistry and greater amount of dopamine and other changes are just side-effect about some unhealthy mental pattern individual is forced to live in. At least non standard treatment models using lesser medicines and more therapy seem to have better long-term outcomes. https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1545-5300.2003.00403.x Why there isn’t anything about them and comparison to current medical model? I think comparing different treatment methods - like there are comparisons about different computer softwares - would be really important thing to read. — Preceding unsigned comment added by 86.115.63.51 (talk) 16:25, 5 July 2018 (UTC)

Cannabis and psychosis

User:2604:6000:1112:cb8e:0:c29e:f485:7627 removed cannabis as a potential trigger of psychosis. I reverted this edit because I am aware of the existence of multiple literature sources supporting this idea, however, I don't have time to scour the article to check if appropriate sources for cannabis as a trigger are included because I have to go to bed but will check tomorrow. If someone disagrees with this reversion, feel free to revert me back. Yanping Nora Soong (talk) 07:42, 8 July 2018 (UTC)

I totally agree with the revert. This is what I wrote on the cannabis (drug) page.Petergstrom (talk) 09:07, 8 July 2018 (UTC)

At an epidemiological level, a dose response relationship exists between cannabis use and risk of psychosis.^[1]^[2]^[3] Although the epidemiological association is robust, evidence to suggest a causal relationship is lacking.^[4] Cannabis has also been associated with an earlier onset of psychosis.^[5]

Psychosis as trauma expressed so listen and do not drug, give advice or label/judge.

It is time to share a vital mind reset & this degenerative paradigm that destroys the beauty of our Nature, including interfering with nature. Psychosis is a scream for help. What if we listened for the whispers of suffering...? ClaireAndersonGraham (talk) 03:07, 13 July 2019 (UTC)

Van Gogh Photo

This may be incorrect or correct, but I'm just confirming, it looks like there was an edit war back and forth on this issue, but there wasn't consensus or an appeal. That other person got shut down, obviously as they weren't using the page as it should be. But, was this handled correctly? I still don't agree that the image should be there, and I don't agree with the source, I'm curious if it genuinely follows wikipedias guidelines. Note that this could be the wrong place for this, please assist. Thanks Tiptup300 (talk) 19:12, 2 April 2019 (UTC)

I completely agree that the image should not be there. This is a page about a medical issue. I don't think that an appropriate image would be an artistic piece that people say has elements of psychosis. Skyturnrouge (talk) 02:06, 4 October 2019 (UTC)

Philosophy

That's my name. I apologize for the confusion, but nowhere in the Wikipedia rules or forum is there a statement which insists that ontological sources be exclusively or intrinsically inferior or superior to epistemology. "Welcome the new guy", however, it is not correct to react to an ontological statement made on the talk page only in the manner which a dependency upon epistemology, (falsifiable, cited sources), often exclusive and vital to medical sections of any main page, might seem to license or permit. I am aware that this is not a social networking site and also that it is necessary to think carefully about what we are saying here. You will be busy but perhaps then a bit hasty. I have plenty of time. For falsifiable accounts to be falsified the vernacular must be sustained, point taken, and again I apologize. - Jonathan Colkett 23:10, 20 November 2019 (UTC)

Signs and symptoms

These two are often confused and conflated, even in some of our potential medical source material. Although the two words are given as a pair in a heading in the main article here, the subsequent material does little to discern the one from the other. Symptoms would be those aspects of any condition which are impressed in a manner which requires that the patient informs of the effect. Signs would be other attributes which are expressed, self-evident and present on the face of things. I say, "would", because that is an over-simplification: for example a, "polymorphous light eruption (PLE)", as distinct from a, "heat rash", can be discerned by the trained eye of a doctor or nurse and its appearance may be recorded both as a sign and as a symptom; strictly speaking, however, the particular nature and distribution of red spots on the skin constitute a discerning, "sign", whist, common, symptoms are the itch and the urge to scratch. Discerning signs from symptoms is going to be important. "Inappropriate behavior", may be a sign of psychosis but can occur alongside other signs for a vast number of other reasons, and it certainly is not a, "symptom". One problem is that our cited sources in psychiatry, (clinical judgement), have formed a disorderly queue for ratification or corroboration by broader psychology and medical science. Sorry for my lacking quoted source material here on the talk page, the abundance of material necessitates that we refine our search. It is with regard to this that I think there is room for improvement to the good work already achieved on the main page. It is possible that the result will be more concise allowing room for anthropological, sociological and cultural perspectives. - Jonathan Colkett 04:36, 22 November 2019 (UTC)

"...abnormal condition..."

These two words seemed to me at first to be in the wrong place. Psychosis itself is not in fact abnormal. Where psychoses are abnormal they are symptoms of the nominal conditions given in the appropriate positions further down the Psychosis page. The use of "abnormal" in the first sentence is perhaps innocent: the phrasing and choice of words rubs well and we are in no doubt as to what the abnormality may be attributed. But, (and it's a big but), prudence warns that it really doesn't belong top-left of the page because a great many readers will look no further before scrolling.Jonathan Colkett 20:31, 20 November 2019 (UTC)

Yes psychosis is abnormal... Doc James (talk · contribs · email) 21:20, 20 November 2019 (UTC)

Psychosis is a psychological, psychiatric term, as are symptoms and abnormal. Don't delete the term's definition or make up your own definition. Changing the related vernacular is not up to any of us. Doczilla _{@SUPERHEROLOGIST} 21:24, 20 November 2019 (UTC)

I will not delete anything because I am mot "edit-warring", I promise. I am just new to all of the mechanics of Wikipedia. You are aware, no doubt, that the necessity of citation of sources is particularly relevant here in line with aspects of what we know nominally as the "Scientific Method". Although that is a bit grandiose, it is perhaps because it is popular and reliable. I know what you mean. But I am not sure that psychiatry, (which sustains clinical judgement and is not, we hope, commonly thought nor statistically proven to be medical science) is our best source. (I am not trying to avoid NPOV here), but without the broader psychology, (thank you), it has a latent tendency to promote paraphrasing presentations of its references and to be used by readers, (where the encyclopedia is apt to inform debate), merely to "beg the question".

What do you think of this question of the "usage" definition of "common" in this tight and global context? - Jonathan Colkett 22:03, 20 November 2019 (UTC)

"Yes psychosis is abnormal..." I suspect that here a question of belief arises, I don't mean to turn the thing on its head but I find your affirmative statement unproven and contentious. Where I sit it is commonly thought to be a little too early to say, but okay, I will leave it alone and respect that, for now. - Jonathan Colkett 05:23, 22 November 2019 (UTC)

On art,"common" versus "frequent" and other cumulative synonymous options.

I make no citations here but combine my apologies, thanks and concise, respectful deference to one authority - who suffered and reverted two rather naive and experimental edits and he hadn't much time for debate - I made a mistake and have learned, but he might know people who can help us to improve the article.

For suggested improvements, neutrality, explanation, reasons and purpose, it is difficult not to write an, "essay" - that's a word via the French on trial and error - and I should apologize in advance for the length of what follows.

I believe that the choice of artwork and artist is good. The picture is a relevant and famous one, loaded with paint and subsequent meaning, it tempts some of us to replace, contrast and compare it with, "The Scream", by Eduard Munch, but there it is.

New to Wikipedia, editing, etc. one first ever, "signed up", edit, to this article, "Psychosis", was defeated and reverted by a reasonable, well qualified and busy body, perhaps a Doctor of Psychology. I accept that, gratefully, but get stuck in a rut, owing to going around in, "catatonic", circles the due, perhaps idiosyncratic notion, that subjects whose objects are, "common", generate commutable, inductive and deductive consistency of affordable, (nominal at least), useful and objective accounts, ring-fenced with common boundaries like sets in, "Venn diagrams"; and be circumspect!

Of course, and sometimes a difference of definition will arise in the English language, (US, UK or, "global", hybrids), whilst either a conservative or radical prescriptive grammar crosses and confuses what the colloquial vernaculars will merely conflate with art. Acceptance of the evolution and usage of words enables us to make sociable choices, but whenever it is written, (or hear it said), that something is, "more common", or, "less common", I become excited, pretentious perhaps, feel about the age of fifty and feel young: people born in 1969, (albeit what, when and wherever, within that year's scope), will at midnight on 31st December 2019, (either precluding or excluding a scarce, legitimate, yet ambivalent party), conclude at one of its ends that their common age is fifty, approximately. Wait a minute, that does, it makes that age more common... - (you think you live!)

Above, is an awful attempt by one editor to explain and apologize to any other for any error of protocol or etiquette made at this stage. Yet improving the, "psychosis", page of the encyclopedia was the original and quintessential purpose. (A perhaps uncommon notion of what, "common", means was a complimentary distraction). But we have our rules and I think the idea is that we all have them.

The aim was otherwise to add a non-psychological, philosophical, but neutral context in which citations complimentary to - but not involved in - contemporary professional psychology could be made, in order to enrich and soothe the public perception of the problem of psychosis.

With all due respect to the humanity of the medical models, professions present and their post-modern predicament, would they not expect some sociological criticisms of psychiatry to be similarly analytical, astute and yet wise to their own historical and potential errors? If neutrality is to be achieved here, balance is required. Within the extant article we are lent some minimal insight into one major problem: that psychosis may be a populous and cultivated social norm. It would not be helpful of a psychological perspective on psychosis to endeavour to prove itself psychotic nor to, "beg the question", and yet evasion of that potential may have generated some suspicion within artistic, cultural or sociological perspectives on psychosis and psychology, resulting in useful contributions on our subject which politely and respectfully avoid psychology.

Inspired by the Artist, would a qualified graduate in Sociology, Philosophy, Theology, all or any, assist me in providing the Psychologists with some attributes, aspects and elevations, portraying the contentious nature of the subject, "psychosis", and written in a well mannered alternative mode?

The given article is authoritative and pretty smooth so far, but it is rather one-eyed and mono-logical, and perhaps a little more or less than neutral, since that authoritative style, of well informed, "life-science", (physics-chemistry-biology), writing, may seem to be paradoxical, even contentious and adversarial, to socially and artistically motivated culture critics. The writers and prior editors of it are not naive to the limits of their own areas of experience and expertise. This editor, alongside various well meaning professionals feels naturally, (although pathologically), qualified with experience of its meaning, but too unprofessional and intrusive to write from those otherwise complimentary perspectives. Since a self-portrait, a landscape or street-scene, any of those achieved by a dead artist, will have been limited by the materials and technique available to the artist at the time, and a still-life is no less lively post-mortem; while taking nothing away from what has been written by psychologists, can we consider the social and political circumstances of the arising of the psychological terminology here? Without the artwork, the entire article lacks cultural depth and in a sense merely represents an ideal conversation between one ubiquitous Doctor and one patient or carer. That Doctor has time after time prompted us to consider here, on a rock in the middle of nowhere, (sometimes regardless of etiology), the differences between the social, the solitary, the scarce, the abundant, the isolated and statistical human, but in taciturn maintenance of one eye only. I had hopes of interacting with the experts here, simply by forging a connection to their work through any correction of simple linguistical compromise. I have since then hoped again, after finding the, "talk-page", button and exploring this question of art. I studied art in order to like what I see until I matured my sense of its evolving definition. But I think it is useful, interesting and beautiful here. Please don't think it morbid. There is a self portrait on the Van Gogh page for that!

Poor old Vincent Van Gogh lived for a while and he and his work can be seen to be boldly indifferent to much of what hindsight has learned of his circumstances. Although perhaps unintentional of the artist it is gathered to be suggestive of a sense of place, yet one which extends beyond the scope of its subject matter in video, through the resultant economy of expression and raw materials and its removal from his minute and withered estate; to the effect that it is, nowadays, almost sublime and symbolic. Don MacLean's post-modern, popular song about the painter and the painting raised awareness of the disparate beauties of art and artist, and having taken the available picture to the listeners of the late twentieth century it compels our millennial attention to the longevity of his expression in contrast with the bare bones of mortality. But that disposition is similar with regard to so many other profound works and contemporary cases, none of which can account for them all. The art of that time develops in us a sense of aspect, and entrance or exit, at the edge, or on the face of, a vaguely familiar but fledgling state of our current affairs. So it may prove important here to rigorously, vigorously and vaguely, citing its creed and critics, identify a contemporary, "paradigm shift". For example, one might say that at some historical time - having identified various works and authors of published scientific papers with titles at particular places and appropriate dates: modernity, during the European Enlightenment, late modernity, afterwards - a conscientious transition is made from what was called, "clinical judgement", (which rested seasonably in the zodiac), to, "medical science", (the last word there being the operative term), which could leave neither ill nor well alone at that. Yet, if professionally possible, one might add that both pharmacological psychiatry and psychoses seem to occupy the same modern temporal space or bridge as post-modern neurology and psychology as a whole, and that in a perpetual feedback phase of ambivalence toward both the scientific method and the former clinical judgement, enduring which each neutrality envies its adversary's specious metaphor, day in day out. It is commonly there that we find ourselves metaphysical, psychological and even psychotic; but most naturally apt to comment, reply, query and edit all accounts.

This is not an expression of opinion but, within the confines of the article's encyclopedic purpose, after paraphrasing it potentially digresses and neatly spirals, like Van Gogh's sky, pulling the rough edges of the concept of psychosis into the wider context.

Sorry for butting in again. I believe this is a marginally better way to proceed. I might try to add something of use to the articulated bones of contention but that's about the size of it.

Ah well and bereft, thank you Doctors, patients and time.

Jonathan Colkett 03:22, 14 November 2019 (UTC) — Preceding unsigned comment added by Jonathan Colkett (talk • contribs)

Okay what reference are you proposing to use to improve what text?

Psychosis is not a symptoms of "social conditions" or at least not per the ref in question. Doc James (talk · contribs · email) 13:46, 19 November 2019 (UTC)

Potential literary references from outwith the accepted and essential psychological domain:

"...drawing on the lives and ideas of some of Europe's most celebrated writers, from Auden to Zola with stop-offs at the likes of Darwin, Kafka, Orwell, Proust and Weil along the way." - I'm on it! - Notice that the Wikipedia/Microsoft (don't know which) spellchecker, so far recognizes all of those writers' names apart from the woman! Jonathan Colkett 12:08, 22 November 2019 (UTC)

I regarded "social conditions" as implicit to the source material but better explicit in the Wikipedia context. Jonathan Colkett 12:08, 22 November 2019 (UTC)

Cannabis

The NIMH says currently "Psychosis may be a symptom of a mental illness, such as schizophrenia or bipolar disorder, but there are other causes, as well. Sleep deprivation, some general medical conditions, certain prescription medications, and the abuse of alcohol or other drugs, such as marijuana, can cause psychotic symptoms."[10] Doc James (talk · contribs · email) 00:03, 4 January 2020 (UTC)

Not really appropriate

The last bit here

"Psychosis has many different causes artificially concluded by psychiatrists and neurologists"

Doc James (talk · contribs · email) 15:51, 18 January 2020 (UTC)

Hi, Yes, the former version is what DSM-5 mentioned. Please refer to DSM-5 page on 823 - 824.--Dustmites are ubiquitous (talk) —Preceding undated comment added 15:54, 18 January 2020 (UTC)

Wait... the reference book should be Arciniegas, David (2018). "24 Psychosis". The American Psychiatric Association Publishing textbook of neuropsychiatry and clinical neurosciences. Arlington, VA: American Psychiatric Association Publishing. p. 823-824. ISBN 978-1-58562-487-4. OCLC 1029092449. Clinical tradition in psychiatry and neurology generally divides the psychoses into two broad categories: primary and secondary...Primary psychoses define the schizophrenia spectrum disorders (e.g., delusional disorder, schizotypal disorder, schizophrenia, schizoaffective disorder) and arise in mood disorders (e.g., major depressive disorder, bipolar disorder) and other idiopathic psychiatric disorders. Secondary psychoses , in contrast, are associated with developmental, degenerative, and acquired neurological conditions such as adrenoleukodystrophy, Alzheimer's disease (AD), Lewy body diseases, stroke, traumatic brain injury, epilepsy, multiple sclerosis, and autoimmune encephalidities, among others...that division of psychoses into primary and secondary types is artificial,... I was misled by the wording DSM-5 on the cover. --Dustmites are ubiquitous (talk) 16:02, 18 January 2020 (UTC)

Were did this text "artificially concluded by psychiatrists and neurologists" come from? Doc James (talk · contribs · email) 16:11, 18 January 2020 (UTC)

that division of psychoses into primary and secondary types is artificial,.--Dustmites are ubiquitous (talk) 16:12, 18 January 2020 (UTC)

But that does not equal "Psychosis has many different causes artificially concluded by psychiatrists and neurologists"?

The exhaustive list also belongs in the body of the article. Doc James (talk · contribs · email) 16:14, 18 January 2020 (UTC)

You sound reasoable. I agree that my paraphrase that attempted to simplify the referenced paragraph can lead to misunderstanding. And I will expand it in the body of the article. What I inferred from the reference was that one psychosis can have different interpretation between psychiatry and neurology. Perhaps both specialty need more communication with each other IMO. Thanks for the concern, Doc James. :) --Dustmites are ubiquitous (talk) 16:28, 18 January 2020 (UTC)

Is first sentence too limited?

I am not sure that the first sentence gives a comprehensive enough definition of psychosis. It seems to define psychosis exclusively as an inability to distinguish between what is real and what is not, but I think there are other signs of psychosis, such as paranoia, tendency towards aggression and tendency towards schizophrenia like symptoms. Vorbee (talk) 16:53, 3 April 2020 (UTC)

Statements about Rush

There's a rather peculiar sentenace about Rush saying that someone who proposed bloodletting made a valuable contribution by: "namely the biological underpinnings of psychiatric phenomenon including psychosis,"

Now the consensus opinion amongst psychiatrists is that psychosis has a biological cause (and indeed from a materialist perspective it *must* since there is nowhere else for the mind to "go"), but this topic is a little contentious and the evidence is far from complete. And of course, the real contention is the the degree to which there might be a psychological intervention and when such a psychologicl intervention could take place.

I'm happy for the article to assert that this is what most psychiatrists think, and include the evidence (e.g. that dopamine-antogonists seem to work, that things like l-dopa can induce psychosis) I'm rather less happy for the text to assert that this is the case in passing like it's doing here. It's a sort of "weasel-asserting-the-consequent".

Can I delete it? :)

--Talpedia (talk) —Preceding undated comment added 20:35, 25 May 2020 (UTC)

^ Marconi, A; Di Forti, M; Lewis, CM; Murray, RM; Vassos, E (September 2016). "Meta-analysis of the Association Between the Level of Cannabis Use and Risk of Psychosis". Schizophrenia bulletin. 42 (5): 1262–9. doi:10.1093/schbul/sbw003. PMC 4988731. PMID 26884547.
^ Moore, TH; Zammit, S; Lingford-Hughes, A; Barnes, TR; Jones, PB; Burke, M; Lewis, G (28 July 2007). "Cannabis use and risk of psychotic or affective mental health outcomes: a systematic review". Lancet. 370 (9584): 319–28. doi:10.1016/S0140-6736(07)61162-3. PMID 17662880.
^ Semple, DM; McIntosh, AM; Lawrie, SM (March 2005). "Cannabis as a risk factor for psychosis: systematic review". Journal of psychopharmacology (Oxford, England). 19 (2): 187–94. doi:10.1177/0269881105049040. PMID 15871146.
^ McLaren, JA; Silins, E; Hutchinson, D; Mattick, RP; Hall, W (January 2010). "Assessing evidence for a causal link between cannabis and psychosis: a review of cohort studies". The International journal on drug policy. 21 (1): 10–9. doi:10.1016/j.drugpo.2009.09.001. PMID 19783132. The contentious issue of whether cannabis use can cause serious psychotic disorders that would not otherwise have occurred cannot be answered based on the existing data
^ Large, M; Sharma, S; Compton, MT; Slade, T; Nielssen, O (June 2011). "Cannabis use and earlier onset of psychosis: a systematic meta-analysis". Archives of general psychiatry. 68 (6): 555–61. doi:10.1001/archgenpsychiatry.2011.5. PMID 21300939.

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[Marconi2016-18] Marconi, A; Di Forti, M; Lewis, CM; Murray, RM; Vassos, E (September 2016). "Meta-analysis of the Association Between the Level of Cannabis Use and Risk of Psychosis". Schizophrenia bulletin. 42 (5): 1262–9. doi:10.1093/schbul/sbw003. PMC 4988731. PMID 26884547.

[Moore_2007-19] Moore, TH; Zammit, S; Lingford-Hughes, A; Barnes, TR; Jones, PB; Burke, M; Lewis, G (28 July 2007). "Cannabis use and risk of psychotic or affective mental health outcomes: a systematic review". Lancet. 370 (9584): 319–28. doi:10.1016/S0140-6736(07)61162-3. PMID 17662880.

[20] Semple, DM; McIntosh, AM; Lawrie, SM (March 2005). "Cannabis as a risk factor for psychosis: systematic review". Journal of psychopharmacology (Oxford, England). 19 (2): 187–94. doi:10.1177/0269881105049040. PMID 15871146.

[21] McLaren, JA; Silins, E; Hutchinson, D; Mattick, RP; Hall, W (January 2010). "Assessing evidence for a causal link between cannabis and psychosis: a review of cohort studies". The International journal on drug policy. 21 (1): 10–9. doi:10.1016/j.drugpo.2009.09.001. PMID 19783132. The contentious issue of whether cannabis use can cause serious psychotic disorders that would not otherwise have occurred cannot be answered based on the existing data

[22] Large, M; Sharma, S; Compton, MT; Slade, T; Nielssen, O (June 2011). "Cannabis use and earlier onset of psychosis: a systematic meta-analysis". Archives of general psychiatry. 68 (6): 555–61. doi:10.1001/archgenpsychiatry.2011.5. PMID 21300939.

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