Differences between Psychosis and Neurosis

Differences between Psychosis and Neurosis

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The increase in mental disorders among the population worldwide is on the rise, so it is important to be informed and know some characteristics and differences between some of them.

As commonly called neurosis and the psychosis, which often cause confusion among many. So that, through the recognition of some characteristics and symptoms, a timely intervention can be made and referral to health professionals, thus avoiding major complications that can diminish the quality of life of the sufferer and those who cohabit or live with them .


  • 1 What is psychosis?
  • 2 What is Neurosis?
  • 3 Characteristics of the neurotic personality
  • 4 Comparative chart of the main differences between Psychosis and Neurosis

What is psychosis?

“Now when I remember it, it seems very ridiculous and I think I should laugh. But it was not. It was a place of indescribable pain. That is what people who have never been crazy cannot understand. How much it hurts delirium. How far reality can be from one's reach. It is a world of despair and frustration. ”John Katzenbach

It is a generic term that refers to some mental disorders, covering several conditions, which cause personality changes, have loss of contact with reality by way of hallucinations or delusions, which is something very characteristic within psychosis, because the person cannot distinguish them, there are alterations of judgment and behavior.

“Sometimes I am not sure that some incidents that I remember clearly would really happen. A memory that seems solid as a stone, is immediately as vaporous as a mist. That is one of the main problems ... You are never sure of things. ”John Katzenbach

Regardless of the special etiology, they have common psychopathological syndromes; they are considered as serious mental disorders, they are characterized by alterations at a global level, which presuppose problems in different cognitive processes such as language, memory, attention, thought and sensory perception. It causes them a split or loss of contact with reality, which usually produces delusions, hallucinations and disorganized behaviors, Many of them tend to have persecutory and paranoid ideas. The symptoms of psychosis They can disable a person to work and develop in various aspects.

There are psychoses that have an organic etiology, are produced by diseases, trauma tumors; others induced by external agents such asalcohol Y drugs stimulants such as methamphetamine and the cocaine, as well as hallucinogens, for example: LSD, to name a few causes. In these cases the disconnection with reality is induced by other agents.

There are brief reactive psychoses, are those that end in remission. As the name implies, last shortly, may be hours or weeks, although they could be periodic, without proper treatment. They are derived because of a trigger factor as a highly stressful or traumatic event, such as the death of a loved one or being victims of some act of violence.

What is neurosis?

The neurotic man closes himself the path to his genuine possibilities, stands before himself on the path to his being power.”Viktor E. Frankl

The concept of neurosis is linked to a more psychodynamic and psychoanalytic interpretation, remains and continues to be used a lot today; It can cover a range of conditions, so its concept has been blurred. Although this term is still used, the WHO (World Health Organization), the APA (American Psychologycal Association), and the DSM-V (Diagnostic and Statistical Manual of Mental Disorders), have integrated it into a wide range of disorders, trying to focus on more clinical and descriptive aspects.

Trying to eradicate in this way its etiology as unique in nervous system conditions, as adjacent frames have been found that have nothing to do with this, while trying to eliminate pejorative connotations that can stigmatize the person. When it does not underlie another disorder, neurosis, is caused by psychological factors, because They come into conflict: impulses or desires, the unconscious defenses of the individual and what is allowed both socially and culturally.

They may present somatic symptoms, not adapt in all cases to certain situations, or respond adequately to stressful events, as their coping strategies are usually not optimal.

Characteristics of the neurotic personality

There are circumstantial characteristics in this type of subjects, which allows us to state the features that define the neurotic personality, this type of character is an expression of intense internal conflicts, since he is subjected to a constant impulsive struggle, he generally fails to harmonize his desires (often repressed), with what he thinks he should do or the society and culture in which he lives demands him to do. The great drama is not being able to identify with the ideal character of his own I, does not usually have a good self-image, or acceptance of himself, which generates anguish, anxietyanger and frustration because he feels that it cannot be done in several aspects that he wishes, thus resorting to certain defense mechanisms, which are not so convenient.

Everyday situations can be overwhelming. So their social interactions are not usually the most optimal, neither for themselves nor for others, they can often have poor impulse control, they have a propensity to accumulate guilt and high nonconformities. They suffer from excessive stress and worries and almost constantly, many refer to having catastrophic thoughts even when there are no real reasons to support these beliefs, so they can fall prey to superstitious beliefs and repetitive or ritual behaviors to free up some anxiety and anxiety, but complicating their lives, as they can result even maladaptive, such as having to wash your hands every time they touch something they perceive is not hygienic or when they shake a person's hand.

From the psychological point of view you can reach the somatic plane and vice versa, thus affecting the integral well-being of the person.

These topics are fascinating and very broad, so I will delineate some distinctions below.

Comparative chart of the main differences between Psychosis and Neurosis



Excision of reality. Disturbance between the I the outer nexus.Contact with reality, although they can present shared attention between what is happening and their internal conflicts that overwhelm them so much, however, they do not lose the reality judgment.
There is no awareness of the condition.There is awareness that "something is wrong."
They present hallucinations (they can be auditory, tactile, visual and sensory) and delusions, their constructions can take fragments of reality and in the escape from reality an active phase of reconstruction continues where it replaces many elements of reality with others created. It surpassed primitive and fragmented.There are usually no hallucinations or delusions. You can use avoidance as an escape to overwhelming situations. They may have attempts to replace reality with some more in line with their desire, but they are aware that many of these constructions are fantasies, for example.
Imbalance of thought, judgment, behavior, will and emotions. What generates social maladjustment.It can remain within the socially accepted limits, although sometimes its coping strategies can be unsatisfactory and not very suitable for the context.
He usually presents a loss of interest in his surroundings and in caring for himself, they can manifest obsessions.They show anguish, anxiety, stress, disproportionately and constantly. They can be somewhat perfectionists and prey to obsessions.
They may have catatonic symptoms, and poor coordination of body movements.When the states of anxiety, panic or anguish are exacerbated they can present nervous tics. Repeat behavior patterns to try to release anxiety, anguish and stress.
Organic, biochemical and environmental factors influence its etiology.Its genesis is rather psychological and can be learned or conditioned behaviors.
Heredity, neurological factors, trauma, strokes, certain types of infections and even toxicological factors could be decisive.Hereditary factors may be important but not determining.
Cognitive processes such as language, attention and thinking can be disorganized and incoherent, sensory perception and memory are also affected. So speech analysis can predict the risk of psychosis.

They can be consistent and use logical thinking. They tend to have a tendency for situations to be under their control and order, since they cannot be so, they generate more anxiety. Your attention may be divided between the present and your concerns for the future, or for your anguish and blame for the past.

They require psychological and psychiatric support because they need psychotropic drugs, hospitalization or equivalent home care, as they are unable to take care of themselves.With work and appropriate psychological treatment they can learn to manage their emotions and react in more adaptive ways. They respond well to different types of psychotherapy.
They generally carry a high risk of self-harm and attempt on their own lives.Few cases end in suicide, although there may be ideation about it.
They may be related to disorders such as those included in the spectrum of schizophrenia, neurocognitive, eating disorders, body dysmorphic,  chronic delusional disorder, psychotic depression, bipolar disorder, dementia, anxiety and panic disorders, mood, dissociative, impulse control, disruptive and behavioral personality disorders, paraphilic, adaptive, risk of suffering from other addictive disorders and substance use, disorders related to trauma and stress. Schizophreniform disorder is another type of psychosis, among others.They can include anxiety, panic, mood, obsessive-compulsive, phobic, somatomorphic, impulse control, disruptive and behavioral disorders, such as intermittent explosive disorder, eating disorders, paraphiliacs, disorders related to trauma and stress, risk of suffering from other addictive disorders and substance use. It includes mood disorders and anxiety. You can see: anxiety disorder (anxiety neurosis).
Serious deterioration in the functioning of the person and their social interactions.The deterioration can be slight in the functioning of the person and his social relations, although this condition could be aggravated if he does not receive adequate psychological treatment.
They have sleep disturbances.They may have abnormalities in sleep.
Projective identification, split, denial, idealization, among others.Some predominant defense mechanisms are: repression, intellectualization, projection, displacement, reactive training, rationalization. Partial dissatisfaction of the drive through substitutive formations (symptoms such as symbolic expression) conflict it and me.
Disorder and severe mental disorder, with alteration of reality, cognitive processes and detriment in social functionality.Emotional and behavioral alterations mainly caused by anxiety.
People with behaviors that might seem extravagant, dramatic, emotional or erratic.People with dramatic, emotional and sometimes erratic behaviors.
Brief reactive psychosisIt happens during periods of great stress such as a traumatic event or the death of a family member, to name a few examples. They usually experience a remission in a few days or weeks, depending on the source of the stress.

It is important to sensitize the general population about these issues so that there is more understanding and empathy. And in turn, people who need professional psychological and psychiatric help can be referred in a timely manner, for their own good and that of others.

Every age has its neuroses, and every time it needs its psychotherapy. ”Viktor E. Frankl


Bibliographic references

  • American Psychiatric Association (2013). DSM-5 Diagnostic and statistical manual of mental disorders (5th Edition). Washington, DC: Masson.
  • Goldman, Howard, H. (1987). General Psychiatry. Mexico: Modern Manual.
  • Vallejo Ruiloba, J. (1992). Introduction to psychopathology and psychiatry. Mexico: Salvat.
  • Katzenbach, J. (2004). The crazy story. Mexico: Editions B.
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