Psychoses
Authorities in the field of the major maladjustments speak of two general categories of psychosis. First, there are those psychoses associated with brain damage, such as behavior changes tliat accompany senility, those related to alcoholism and other drug addiction, and brain damage by tumors. Some psychoses may have a genetic base, for example, schizophrenia which we shall discuss below. Second, there are some psychoses in which there is no evidence of brain damage, such as paranoia which we shall also discuss. Some persons with tangible brain damage may recover after thr; cause of the damage is removed. For example, someone whose psychosis is associated with an infection, like syphilis, may show some behavioral improvement as the infection is cleared up, even though brain damage itself is irreversible. Such a recovery of function may occur, if damage has not gone too far, because of the brain's facility to compensate for destruction of some of its cells by having neighboring tissue take over.
Although neurotic and psychotic symptoms overlap in part, neurotic persons seldom become psychotic, even in the face of extreme pressures. Psychotic behavior usually develops suddenly. Sometimes there are borderline symptoms between the neurotic and the psychotic which are called prepsychotic. In most cases, however, psychotic reactions are clearly recognized by others. On the other hand, the patient rarely recognizes that anything is wrong. To the psychotic, there is little distinction between the real world and the unreal, inner world of fantasy.
Psychotic disorders are marked by four conditions. First, the disorders are accompanied by disorientation as to time, place, and person, and by inappropriate behavior, such as profane la.nguage, indiscriminate sexual overtures, and extreme physical aggression. Second, the disorders are accompanied by delusions. These false beliefs usually center on sin and guilt, delusions of persecution and grandeur, and sometimes feelings that one is being eaten away by some disease. Third, psychoses commonly involve hallucinations, such as hearing voices. Fourth, exaggerated emotional disturbances are characteristically found among psychotic patients.
