What is the Difference between Mania and Psychosis?

28 Aug
“The term psychotic has historically received a number of different definitions, none of which has achieved universal acceptance. The narrowest definition of psychotic is restricted to delusions or prominent hallucinations, with the hallucinations occurring in the absence of insight into their pathological nature. A slightly less restrictive definition would also include prominent hallucinations that the individual realizes are hallucinatory experiences.

Broader still is a definition that also includes other positive symptoms of Schizophrenia (i.e., disorganized speech, grossly disorganized or catatonic behavior). Unlike these definitions based on symptoms, the definition used in earlier classifications (e.g., DSM-II and ICD-9) was probably far too inclusive and focused on the severity of functional impairment. In that context, a mental disorder was termed “psychotic” if it resulted in “impairment that grossly interferes with the capacity to meet ordinary demands of life.” The term has also previously been defined as a “loss of ego boundaries” or a “gross impairment in reality testing.”

“In this manual (the DSM-IV), the term psychotic refers to the presence of certain symptoms. However, the specific constellation of symptoms to which the term refers varies to some extent across the diagnostic categories. In Schizophrenia, Schizophreniform Disorder, Schizoaffective Disorder, and Brief Psychotic Disorder, the term psychotic refers to delusions, any prominent hallucinations, disorganized speech, or disorganized or catatonic behavior. In Psychotic Disorder Due to a General Medical Condition and in Substance-Induced Psychotic Disorder, psychotic refers to delusions or only those hallucinations that are not accompanied by insight. Finally, in Delusional Disorder and Shared Psychotic Disorder, psychotic is equivalent to delusional.”

A manic episode is defined as a period of time when there is abnormally and persistently elevated, expansive, or irritable mood.

Mania and psychosis can coincide. A manic patient is often (but not always) psychotic, but a psychotic patient may be so due to schizophrenia, substance use, or another underlying disorder

Submitted by M. Smith.

References: DSM-IV-TR. Diagnostic and Statistical Manual  of Mental Disorders, Fourth Edition, Text Revision. APA, 2000.; picture

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