Differences between Psychosis and Neurosis

Anthony Golden
Differences between Psychosis and Neurosis

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.

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


  • What is Psychosis?
  • What is Neurosis?
  • Neurotic personality characteristics
  • Comparative table of the main differences between Psychosis and Neurosis
    • Bibliographic references

What is Psychosis?

“Now when I remember it, it all seems so ridiculous to me and I think I should laugh. But it wasn't. It was a site of indescribable pain. That is what people who have never been crazy cannot understand. How much delirium hurts. How far reality can be from one's grasp. It is a world of despair and frustration. " John katzenbach

It is a generic term that refers to some mental disorders, they cover several conditions, which cause changes in the personality, they have loss of contact with reality in the form of hallucinations or delusions, which is something very characteristic within psychoses, since the person cannot distinguish between them, there are impaired judgment and behavior.

“Sometimes I am not sure that some incidents that I clearly remember really happened. A memory that seems solid as a stone, immediately afterwards it turns out to me as vaporous as a mist. That is one of the main problems… You are never sure about 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 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. Symptoms of psychosis can disable a person to work and develop in various ways.

There are psychoses that have an organic etiology, are produced by diseases, tumors, trauma; others induced by external agents such as alcohol and stimulant drugs such as methamphetamines and 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 the short reactive psychoses, they are those that end in remission. As their name indicates, they last a short time, they can be hours or weeks, although they could be periodic, without adequate treatment. They are derived from a triggering factor such as a highly stressful or traumatic event, such as the death of a loved one or being the victims of an act of violence.

What is Neurosis?

"The neurotic man closes himself the way to his genuine possibilities, he stands before himself on the way to his power to be." Viktor E. Frankl

The concept of neurosis is linked to a more psychodynamic and psychoanalytic interpretation, it remains and is still widely used today; it can encompass 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 , Thus trying to focus on more clinical and descriptive aspects.

In this way, trying to eradicate its etiology as the only one in nervous system disorders, since adjacent frames have been found that have nothing to do with this, while at the same time trying to eliminate pejorative connotations that can stigmatize the person. When it does not underlie another disorder, neurosis, it is caused by psychological factors, as they conflict: impulses or desires, the individual's unconscious defenses and what is allowed both socially and culturally.

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

Neurotic personality characteristics

There are circumstantial characteristics in this type of subject, which allows us to propose the traits that define the neurotic personality, this type of character is an expression of intense internal conflicts, as it is subjected to a constant drive struggle, generally it cannot harmonize its desires (many times repressed), with what he thinks he should do or the society and culture in which he lives demands that he do. The great drama lies in not being able to identify with the ideal character of his own I, he does not usually have a good self-image, nor acceptance of himself, which generates anguish, anxiety, anger and frustration, because he feels that he cannot be fulfilled. in various aspects that you want, 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, many times they can 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 report having catastrophic thoughts even when there are no real reasons that support these beliefs, so they can be prey to superstitious beliefs and repetitive behaviors or rituals to release a little anguish and anxiety. , but complicating their lives more, as they can even be maladaptive, such as having to wash their hands every time they touch something that they perceive to be unsanitary or when they shake a person's hand.

From the psychological point of view, the somatic level can be reached and vice versa, thus affecting the overall well-being of the person..

These topics are fascinating and very broad, so I will outline a few distinctions below..

Comparative table of the main differences between Psychosis and Neurosis



Excision of reality. Disturbance between the Self and the external nexus.Contact with reality, although they may present shared attention between what is happening and their internal conflicts that overwhelm them so much, however, they do not lose their judgment of reality.
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 many elements of reality are replaced by other created ones. Primitive and fragmented superego.There are usually no hallucinations or delusions. You can use avoidance as an escape from stressful situations. They may have attempts to replace reality with some more according to 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.You can stay within socially accepted limits, although sometimes your coping strategies can be unsatisfactory and not very appropriate for the context.
They tend to have a loss of interest in their surroundings and in caring for themselves, they may manifest obsessions.They manifest anguish, anxiety, stress, disproportionately and constantly. They can be a bit perfectionists and prey to obsessions.
They may have catatonic symptoms, and poor coordination of body movements.When states of anxiety, panic or anguish are exacerbated, they can present nervous tics. Repeat behavior guidelines to try to release anxiety, distress, 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, cerebrovascular accidents, certain types of infections and even toxicological factors could be determining factors..Hereditary factors may be important but not decisive.
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, as they cannot be so they generate more anxiety. Your attention may be divided between the present and your concerns for the future, or your past anguish and guilt..

They require psychological and psychiatric support as they need psychotropic drugs, hospitalization or equivalent home care, as they are unable to take care of themselves.With work and proper 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 an attempt on their own life.Few cases end in suicide, although there may be ideas about it.
They can 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 disorders, dissociative , impulse control, disruptive and behavioral, paraphilic, adaptive personality disorders, risk of other addictive and substance use disorders, trauma and stress-related disorders. Schizophreniform disorder is another type of psychosis, among others.They can include anxiety, panic, mood disorders, obsessive-compulsive, phobic, somatoform, impulse control, disruptive and behavioral disorders, such as intermittent explosive disorder, eating disorders, paraphilic, trauma and stress-related disorders, risk of other addictive and substance use disorders. It includes mood and anxiety disorders. You can see: anxiety disorder (anxiety neurosis).
Serious impairment in the functioning of the person and their social interactions.The deterioration can be slight in the functioning of the person and their social relationships, although this condition could be aggravated if it does not receive adequate psychological treatment.
Have sleep disturbances.They may have sleep disturbances.
Projective identification, split, negation, idealization, among others.Some predominant defense mechanisms are: repression, intellectualization, projection, displacement, reactive training, rationalization. Partial dissatisfaction of the drive by means of substitute formations (symptoms as symbolic expression) conflict it and I.
Severe mental disorder and disorder, with alteration of reality, cognitive processes and impairment in social functionality.Emotional and behavioral disturbances mainly caused by anxiety.
People with behaviors that may seem quirky, dramatic, emotional, or erratic.People with dramatic, emotional behaviors and can sometimes be erratic.
Brief reactive psychosis, happens during periods of great stress such as a traumatic event or the death of a family member, to name a few examples. They generally experience a remission within 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..

"Each age has its neuroses, and each age 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 story of the madman. Mexico: Editions B.

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