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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.
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Delusions. Delusions occurring in delusional disorder
are more plausible, but still patently untrue. In some cases,
delusions may be accompanied by feelings of
paranoia. |
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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. |
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Disorganized speech. Psychotic patients, especially
those with schizophrenia, often ramble on in incoherent, nonsensical
speech patterns. |
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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. |
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| Brief Psychotic 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.
Delusional DisorderThe 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.
Psychotic Disorder Due to a Medical ConditionPsychosis 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.
Substance-Induced Psychotic DisorderPsychosis 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.
Schizophrenia, Schizophreniform and
Schizoaffective DisorderPsychosis 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. |
