What Is the Difference Between Psychosis and Schizophrenia?

While sometimes used interchangeably, psychosis and schizophrenia are not the same. The biggest difference between psychosis and schizophrenia is that:

• Psychosis is a symptom that refers to losing touch with reality.
• Schizophrenia is a disorder characterized by a number of symptoms, including psychotic symptoms.

Individuals who have schizophrenia experience symptoms of psychosis, along with other symptoms. However, individuals experiencing psychosis do not necessarily have schizophrenia.

This article explains the differences between psychosis and schizophrenia, and addresses how they are linked. It will also explore each condition and cover symptoms, as well as treatment options.

What Is Psychosis?

Psychosis describes a loss of contact with reality. A period of psychosis is called a psychotic episode.

A psychotic episode can occur on its own, or may be associated with:

• A mental disorder, like schizophrenia
• Sleep deprivation
• Certain prescription medications
• Substance use
• A medical condition, like dementia

What Are the Symptoms of Psychosis? 

Symptoms associated with psychosis include:

• Hallucinations: Hallucinations describe when an individual senses things that aren't actually real. This can include hearing, seeing, smelling, tasting, and feeling things that feel real, but are not.
• Delusions: Delusions are false beliefs that are not based in reality. A person experiencing delusions will not change their beliefs even when given evidence that the belief is false. An example may be believing a famous person is in love with them, despite never meeting.
• Agitation: This describes excessive physical movement or verbal activity. Symptoms of agitation can also include emotional distress, restlessness, or pacing.
• Disorganized thinking or behavior: This describes jumbled or difficult to understand speech, writing, or thinking. This can make it difficult for someone to communicate with others and keep their thoughts straight.

What Are Other Types of Psychotic Disorders?

Mental disorders associated with symptoms of psychosis are known as psychotic disorders. In addition to schizophrenia, other psychotic disorders include:

• Schizoaffective disorder: Symptoms of this disorder may include hallucinations, delusions, and disorganized thinking, along with either a depressed or manic mood.
• Schizophreniform disorder: With this disorder, a person develops the symptoms of schizophrenia for a period shorter than six months.
• Delusional disorder: This describes strong, unchangeable beliefs in things that are not real or true, without experiencing hallucinations.
• Brief psychotic disorder: This describes psychotic symptoms with a sudden onset, lasting one month or less. Another episode may or may not occur in the future.
• Substance-induced psychotic disorder: This describes psychosis brought on by the use of substances such as cannabis, cocaine, ecstasy, and alcohol.
• Psychotic disorder due to a medical condition: This describes conditions such as brain tumors, brain infections, or strokes that can lead to psychotic symptoms.

What Is Schizophrenia?

Schizophrenia is a mental health disorder that impacts thought processes, emotions, and behavior. To receive a diagnosis of schizophrenia, an individual must meet the criteria described in the Diagnostic and Statistical Manual of Mental Disorders (DSM–5).

Criteria includes experiencing two of the following symptoms more often than not during a one month period. Symptoms include:

• Delusions
• Hallucinations
• Disorganized speech
• Disorganized or catatonic behavior, which describes restlessness, lack of movement, and/or erratic movement
• Negative symptoms, such as minimal or no emotional expression and lack of motivation

What Are the 3 Stages of Schizophrenia?

Schizophrenia occurs in stages.

1. Prodromal phase: During this phase, which can last from weeks to years, symptoms develop gradually and typically involve loss of interest in activities, social withdrawal, or difficulty concentrating. Intense fixation with ideas or subjects can also develop.
2. Active phase: This is known as the acute stage of schizophrenia and is when psychotic symptoms occur. Symptoms can develop gradually after a prodromal phase or appear suddenly.
3. Residual phase: During this period, symptoms have reduced, but the individual may feel withdrawn and have difficulty focusing.

While the length of these stages differs from person to person, these phases tend to occur in sequence and may recur throughout the life of a person with schizophrenia.

What Psychotic Symptoms Are Associated With Schizophrenia?

Psychotic symptoms, also known as positive symptoms, associated with schizophrenia include:

• Delusions
• Hallucinations
• Disorganized thought and speech
• Disorganized behavior

What Are Examples of Psychosis in Schizophrenia?

Psychotic symptoms can manifest in individuals with schizophrenia as:

• Paranoia, like the belief that they are being spied on or being controlled by outside forces
• A belief that others can read their thoughts
• Believing that ordinary events hold special meaning specifically to them, like that a person is sending them messages through the television
• Delusions of grandeur, such as believing they are of great importance, are very powerful, or have special powers
• Hearing noises or voices that aren't there, like hearing commands
• Switching quickly from subject to subject when speaking
• Making up words
• Discussing ideas that seem unrelated
• Having difficulty performing everyday tasks such as self-care and hygiene
• Difficulty planning
• Experiencing symptoms of catatonia, including physical rigidity, repetitive movements, or lack of a response to their environment

How Do Antipsychotics Work?

Symptoms of psychosis may be treated with antipscyhotic medication. Antipsychotics may work by blocking the effects of the overactivity of a brain chemical called dopamine, which impacts emotions, planning, and memory. This overactivity is thought to contribute to the cause of psychotic symptoms.

Antipsychotic drugs generally fall into two categories:

• Atypical, or second generation, antipsychotics: These medications inhibit dopamine action and affect levels of serotonin, a chemical related to mood. They are usually the first choice to treat schizophrenia.
• Typical, or first generation, antipsychotics: These antipsychotics inhibit dopamine activity, but do not affect serotonin.

Antipsychotic medications work differently for each individual and may cause side-effects. Speak with your healthcare provider to determine the risks and benefits of these medications.

Summary

Psychosis is a symptom that refers to a loss of touch with reality. Schizophrenia is a disorder with various symptoms, including psychotic symptoms. Individuals with schizophrenia experience psychotic symptoms, however, those with psychotic symptoms don't necessarily have schizophrenia.

Psychotic symptoms may be caused by a mental health disorder, sleep deprivation, a medical condition, substance use, or certain medications. Symptoms of psychosis include hallucinations, delusions, agitation, and disorganized thinking and behavior.

Schizophrenia is a mental health disorder that includes symptoms such as delusions, hallucinations, disorganized speech or behavior, as well as negative symptoms like low emotional expression. Schizophrenia has three stages:

• Prodromal phase, which includes symptoms such as withdrawal, difficulty focusing, and lack of interest in typical activities
• Active phase, which is when psychotic symptoms tend to occur
• Residual phase, which is when symptoms have lessened, however the individual may still feel withdrawn

Psychotic symptoms associated with schizophrenia include delusions, hallucinations, and disorganized thoughts, speech, and behavior.

Psychotic symptoms may be treated with an antipsychotic medication, which aims to decrease symptoms. These types of medications may cause side-effects, so it's important to speak with your healthcare provider to determine the best treatment for your needs.