Multiple Sclerosis Symptoms
Psychosis - "A severe mental disorder, with or without organic damage, characterized by derangement of personality and loss of contact with reality and causing deterioration of normal social functioning."
Psychosis in multiple sclerosis, while not common, does occur in approximately 5% of cases, although it is probably under reported.
Neurological changes, alterations in brain chemistry or severe stress such as that brought on by diagnosis or the impact of multiple sclerosis, can lead to the development of psychosis. See also Adjustment Disorder
Psychosis may also occur as a result of treatment with steroids or other drugs.
The duration and intensity of the psychotic episode can be variable, ranging from mild loss of contact with reality, to severe loss of a grasp on reality, with full delusional episodes; to complete catatonia.
Although not proven, it is thought that psychosis may be the result of damage to the area of the brain known as the temporal lobe.
MRI studies have shown statistical significance of lesion-load around the periventricular areas, particularly the temporal horn, and the development of psychosis.
Symptoms of Psychosis:
- Delusions. Delusions occurring in delusional disorder are more plausible, but still patently untrue. In some cases, delusions may be accompanied by feelings of paranoia.
- Hallucinations. Psychotic patients see, hear, smell, taste, or feel things that aren't there. Schizophrenic hallucinations are typically auditory or, less commonly, visual; but psychotic hallucinations can involve any of the five senses.
- Disorganized speech. Psychotic patients, especially those with schizophrenia, often ramble on in incoherent, nonsensical speech patterns.
- Disorganized or catatonic behavior. The catatonic patient reacts inappropriately to his environment by either remaining rigid and immobile or by engaging in excessive motor activity. Disorganized behavior is behavior or activity which is inappropriate for the situation, or unpredictable.
Types of psychosis:
- Brief psychotic disorder
- Delusional disorder
- Psychotic disorder due to a medical condition
- Substance-induced psychotic disorder
- Schizophrenia, schizophreniform disorder, and schizoaffective disorder
Trauma and stress can cause a short-term psychosis (less than a month's duration) known as brief psychotic disorder. Major life-changing events such as the death of a family member or a natural disaster have been known to stimulate brief psychotic disorder in patients with no prior history of mental illness.
The exact cause of delusional disorder has not been conclusively determined, but potential causes include heredity, neurological abnormalities, and changes in brain chemistry. Some studies have indicated that delusions are generated by abnormalities in the limbic system, the portion of the brain on the inner edge of the cerebral cortex that is believed to regulate emotions.
Psychosis may also be triggered by an organic cause, termed a psychotic disorder due to a general medical condition. Organic sources of psychosis include neurological conditions (for example, epilepsy and cerebrovascular disease), metabolic conditions (for example, porphyria), endocrine conditions (for example, hyper- or hypothyroidism), renal failure, electrolyte imbalance, or autoimmune disorders.
Psychosis is also a known side effect of the use, abuse, and withdrawal from certain drugs. Recreational drugs, such as hallucinogenics, PCP, amphetamines, cocaine, marijuana, and alcohol, may cause a psychotic reaction during use or withdrawal.
Certain prescription medications such as steroids, anticonvulsants, chemotherapeutic agents, and antiparkinsonian medications may also induce psychotic symptoms.
Psychosis in schizophrenia and perhaps schizophreniform disorder appears to be related to abnormalities in the structure and chemistry of the brain, and appears to have strong genetic links; but its course and severity can be altered by social factors such as stress or a lack of support within the family. The cause of schizoaffective disorder is less clear cut, but biological factors are also suspected.
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