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Psychosis refers to an abnormal condition of the mind and is a generic psychiatric term for a mental state often described as a "loss of contact with reality." People with psychosis are described as psychotic. People experiencing psychosis may exhibit some personality changes and thought disorder. Depending on its severity, this may be accompanied by unusual or bizarre behavior as well as difficulty with social interaction and impairment in carrying out daily life activities.

Signs and symptoms


A hallucination is defined as sensory perception in the absence of external stimuli. Hallucinations are different from illusions (or perceptual distortions) which are the mis-perception of external stimuli. Hallucinations may occur in any of the senses and take on almost any form, which may include simple sensations (such as lights, colors, tastes, and smells) to experiences such as seeing and interacting with fully formed animals and people, hearing voices, and having complex tactile sensations.

Auditory hallucinations (particularly experiences of hearing voices) are the most common and often prominent feature of psychosis. Hallucinated voices may talk about, or to, the person, and may involve several speakers with distinct personalities. Auditory hallucinations tend to be particularly distressing when they are derogatory, commanding, or preoccupying.


Main article: 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 them) or grandiose (person believing that he or she has special powers or skills). Depressed people might have delusions consistent with their low mood (such as delusions that they have sinned or have contracted serious illness). 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 (such as ethnic, religious, superstitious, or political beliefs).

Thought disorders

Thought disorder describes an underlying disturbance to conscious thought and is classified largely by its effects on speech and writing. Affected people show loosening of associations or a disconnection and disorganization of the semantic content of speech and writing. In the severe form, speech becomes incomprehensible and it is known as "word salad."


Catatonia describes a profoundly agitated state in which the experience of reality is generally considered impaired. There are two primary manifestations of catatonic behavior. The classic presentation is a person who does not move or interact with the world in any way while awake. This type of catatonia presents with waxy flexibility. Waxy flexibility is when someone physically moves part of a catatonic person's body and the person stays in the position even if it is bizarre and otherwise nonfunctional (such as moving a person's arm straight up in the air and the arm staying there).

The other type of catatonia is more of an outward presentation of the profoundly agitated state described above. It involves excessive and purposeless motor behavior, as well as extreme mental preoccupation that prevents an intact experience of reality. An example is someone walking very fast in circles to the exclusion of anything else with a level of mental preoccupation (meaning not focused on anything relevant to the situation) that was not typical of the person prior to the symptom onset. In both types of catatonia there is generally no reaction to anything that happens outside of them.

Delusional parasitosis

Delusional parasitosis, also known as Ekbom's syndrome,[1][2] is a form of psychosis in which victims acquire a strong delusional belief that they are infested with parasites, whereas in reality no such parasites are present.[3]

Sufferers may injure themselves in attempts to rid themselves of the "parasites." Some are able to induce the condition in others through suggestion, in which case the term folie à deux may be applicable.[4][5] Nearly any marking upon the skin, or small object or particle found on the person or his clothing can be interpreted as evidence for the parasitic infestation, and sufferers commonly compulsively gather such "evidence" and then present it to medical professionals when seeking help.[6]

In the context of psychoactive substances, it is particularly common during stimulant psychosis after prolonged chronic usage of cocaine.[7]

Psychoactive substances

Compounds within our psychoactive substance index which may cause this effect include:

See also


  1. Rapini, Ronald P.; Bolognia, Jean L.; Jorizzo, Joseph L. (2007). Dermatology: 2-Volume Set. St. Louis: Mosby. ISBN 1-4160-2999-0.
  2. Ekbom syndrome: a delusional condition of "bugs in the skin" ( / NCBI) |
  3. Webb, J.P., Jr. (1993). "Case histories of individuals with delusions of parasitosis in southern California and a proposed protocol for initiating effective medical assistance". Bulletin of the Society of Vector Ecologists 18 (1): 16–24.
  4. Ekbom syndrome: a delusional condition of "bugs in the skin" ( / NCBI) |
  5. Koblenzer, C.S. (1993). "The clinical presentation, diagnosis and treatment of delusions of parasitosis--a dermatologic perspective".Bulletin of the Society of Vector Ecologists 18 (1): 6–10.
  6. Webb, J.P., Jr. (1993). "Case histories of individuals with delusions of parasitosis in southern California and a proposed protocol for initiating effective medical assistance". Bulletin of the Society of Vector Ecologists 18 (1): 16–24.
  7. Cocaine Bugs: A Case Report of Cocaine-Induced Delusions of Parasitosis | [1]