1. Psychosis
   1. Loss of contact with reality
   2. Classic symptoms
      1. Delusions
         1. Ideas strongly believed but have no basis in fact
         2. Delusions of grandeur, of control, of persecution
         3. Fixed, false, bizarre beliefs
      2. Hallucinations
         1. Perceptions that occur in the absence of external stimuli
            1. sight, sound etc
            2. Abnormal sensory experience
   3. Most commonly appears in form of schizophrenia (also in mania, dementia, drug abuse etc)
   4. Multiple Sclerosis
      1. Reiss et al (2006)
      2. Onset of psychosis with increase of MS pathology in left temporal lobe
      3. Auditory and visual hallucinations
      4. Paranoia with delusions
   5. Research over the last 4 decades has revealed the importance of dopamine (DA), D2 receptors, and the basal ganglia in psychotic thinking.
      1. Morris & Murray (2009)
   6. SHANE
      1. Sheehan & Thurber (2006)
      2. Man with a history of head trauma, paraplegia, and chronic mental illness
      3. SPECT found convexity of the temporal lobe; in the location of the traumatic blow suffered 18 years earlier
      4. Patient was reclassified with an organic psychosis and as an individual who might benefit more from medications to treat temporal lobe irritability rather than antipsychotic medications.
      5. hoped that he might be reclassified as someone with TBI
      6. Organic findings and recommendations were ignored - classified 'psychiatric case'
      7. Attempted suicide under a month after being discharged
   7. SEBASTIAN
      1. Seeck et al (
      2. Man with a history of head trauma, paraplegia, and chronic mental illness
      3. SPECT found convexity of the temporal lobe; in the location of the traumatic blow suffered 18 years earlier
      4. Patient was reclassified with an organic psychosis and as an individual who might benefit more from medications to treat temporal lobe irritability rather than antipsychotic medications.
      5. hoped that he might be reclassified as someone with TBI
      6. Organic findings and recommendations were ignored - classified 'psychiatric case'
      7. Attempted suicide under a month after being discharged
2. Schizophrenia
   1. Subtype of psychosis
   2. NOT split personality
   3. Heterogeneous
      1. Great variation in symptoms, triggers, cause and responsiveness to treatment
      2. Topic
         1. Believed by some to be group of distinct disorders with common features
            1. e.g. 'cenesthetic schizophrenia' Huber (1992)
   4. Not necessarily linked to violence
   5. Schizophrenia signs linked to left hemisphere dysfunction - Pierre Flor-Henry 1969
   6. Positive Symptoms
      1. Hallucinations
         1. Hallucinations - more auditory than visual
         2. Hearing own thoughts from other voice / arguing voices
         3. Voices commenting on patient's behaviour
      2. Delusions
         1. Thoughts are broadcast/transmitted
         2. Thoughts not own
         3. Thoughts are stolen
         4. Feelings and behaviour controlled by external force
         5. Problems of agency due to passivity symptoms
   7. Negative Symptoms
      1. Behavioural Deficits
         1. Precede and endure beyond acute episode
         2. Predict poor life quality
         3. Danger of diagnosing these symptoms
      2. The 5 'A's
         1. Asociality
            1. Dislike of social interaction (usually first symptom)
         2. Avolition
            1. Apathy, feeling drained of energy and lacking interest in normal goals
         3. Alogia
            1. Reduction in speech or speech content
         4. Ahedonia
            1. Inability to experience pleasure
         5. Flat affect
            1. Show almost no emotions
   8. Disorganised Symptoms
      1. Disorganised Speech
         1. Poor organisation of thoughts and comprehension of content
         2. Predict poor life quality
         3. Danger of diagnosing these symptoms
      2. Bizarre behaviour
         1. Unusual clothes, collecting of rubbish, sexually inappropriate behaviour
3. Visual Hallucinations
   1. Simple
      1. Occipital lobe deficits
   2. Complex
      1. Cortical release phenomenon
   3. A common (10–15% prevalence) and often distressing consequence of vision loss