In some cases, brain damage can lead to psychosis but the term "psychosis" simply refers to a set of symptoms or type of symptom that occur in psychotic illnesses such as schizophrenia, typically involving loss of contact with reality, impaired judgement, hallucinations, delusions, and thought disorder.
Psychosis doesn't damage the brain.
The absence of strong correlations suggests that untreated initial psychosis has no direct toxic neural effects.
Objective: Studies of patients experiencing their first episode of psychosis have demonstrated that they typically remain undiagnosed and untreated for 1?2 years. It has been postulated that prolonged untreated psychosis may have serious effects:
This study investigated the relationships between duration of untreated initial psychosis and neurocognitive functioning and high-resolution imaging brain measurements.
- poor response to neuroleptic medications,
- poor clinical outcomes, and
- direct neurotoxicity.
Method: A total of 156 subjects with DSMIV schizophrenia, schizophreniform disorder, or schizoaffective disorder were evaluated during their first episode of psychosis. Measurements included nine domains of neurocognitive functioning, volumetric measures of total brain tissue, gray and white matter, and CSF, and measures of brain surface anatomy.
Results: The mean duration of untreated initial psychosis was 74.3 weeks. Correlations between neurocognitive functioning, brain volumetric measurements, and surface anatomy measurements with duration of untreated initial psychosis were weak; none reached statistical significance. When the group was divided on the basis of median duration of untreated initial psychosis, there were again no significant differences between the groups with long and short duration of untreated initial psychosis except on two measures (verbal memory and cortical sulcal depth).
Conclusions: The absence of strong correlations suggests that untreated initial psychosis has no direct toxic neural effects. These results suggest that large-scale initiatives designed to prevent neural injury through early intervention in the prepsychotic or early psychosis phase may be based on incorrect assumptions that neurotoxicity or cognitive deterioration may be avoided. Nevertheless, early treatment is justified because it reduces suffering.