Psychosis vs. Schizophrenia: What Are the Differences?

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Psychosis is a mental health symptom that involves losing touch with reality and experiencing hallucinations and delusions. It can have several causes and is one of the most distinguishable symptoms of schizophrenia. Schizophrenia is a mental health condition that distorts how a person thinks, acts, feels, and behaves. Psychosis can also occur without schizophrenia. 

Several conditions and situations could lead to the development of psychosis. Psychosis is a symptom of several mental health conditions but is typically not considered a disorder itself. Psychosis disrupts a person’s thoughts and perceptions to the point that they find it challenging to recognize what is real and what isn’t. 

Learn more about the differences between psychosis and schizophrenia and how to seek proper help for each condition.

Psychosis and Schizophrenia Symptoms

Psychosis and schizophrenia have unique symptoms, some of which resemble each another.

Psychosis Symptoms

In most cases, psychosis is indicative of an underlying condition. It’s a symptom of several mental health conditions. Symptoms of psychosis can be broadly classified into hallucinations, delusions, and disorganization.

Signs of a psychotic break include: 

  • Hearing voices that aren't there
  • Seeing things that aren’t there 
  • Believing fixed, false beliefs
  • Thinking your thoughts and behaviors are being controlled by something or someone else 

Schizophrenia Symptoms 

Symptoms of schizophrenia are classified into positive and negative symptoms. Positive symptoms include changes in thoughts and behavior. In contrast, negative symptoms include character changes such as lack of motivation, talking less, diminished facial expressions, and lack of interest in social activities.

The most recognizable aspects of schizophrenia are the positive symptoms of psychosis.

Some of the most common symptoms of schizophrenia include: 

  • Hearing or seeing things that aren’t there 
  • Experiencing paranoia
  • Thinking in an unusual or illogical way 
  • Having and expressing muted emotions 
  • Difficulty processing new information and making decisions 
  • Becoming socially withdrawn
  • Difficulty paying attention 
Psychosis
  • Hearing/seeing things that aren't there

  • Believing fixed, false beliefs

  • Thinking your thoughts and behaviors are controlled by something or someone else

Schizophrenia
  • Hearing/seeing things that aren't there

  • Experiencing paranoia

  • Thinking in an unusual or illogical way

Causes of Psychosis and Schizophrenia

Schizophrenia is a mental illness where psychosis is its core feature; however, psychotic symptoms can occur in a variety of other medical, mental health, and substance use disorders.

However, a person can have schizophrenia and not experience positive symptoms of psychosis in the early and residual stages of schizophrenia. 

Causes of Psychosis 

It’s not entirely understood what causes psychosis. Several factors and triggers have been linked to the development of psychosis.

Some of them include: 

  • Mental disorders: The most common cause of psychosis is the development of a mental health condition. Schizophrenia, dementia, bipolar disorder, and schizoaffective disorder are common conditions that present with psychosis.
  • Substance abuse: Abusing illegal substances and drugs such as LSD and amphetamines puts you at a greater risk of developing psychosis. 
  • Brain injury: Traumatic brain injuries have also been known to trigger psychosis in susceptible individuals.

Causes of Schizophrenia 

Researchers are still working to determine the exact cause of schizophrenia. A combination of genetic, physical, environmental, and psychological factors has been identified as the most likely reason for a person to develop the condition.

The following factors put a person at an increased risk of developing the condition:

  • Genetics: There is a strong genetic contribution to the development of schizophrenia.
  • Brain structure: Some research shows that people with schizophrenia have specific differences in their brain structure. However, this is often slight and isn’t present in everyone with the condition.
  • Stress: A high-stress situation could trigger the emergence or exacerbation of symptoms of schizophrenia in some people. While stress can’t technically cause the condition, it could trigger symptoms in people who are already vulnerable to developing the disorder.
  • Substance abuse: Like with psychosis, substance abuse can also trigger the development of schizophrenia in people who are already susceptible to developing the condition.

Diagnosing Psychosis and Schizophrenia 

Diagnosing psychosis and schizophrenia typically involves a lot of the same processes. Your doctor will look at your psychiatric, medical, and family history, and conduct a physical and mental status examination.

Psychosis Diagnosis

Identifying psychosis will involve investigating mental health conditions you may have in which psychosis can emerge. A doctor will look into your medical and family history as well.

This will include questions about disorders in your family, medications you are on, details about your symptoms, and any other questions that can help them make an accurate diagnosis. A psychiatric evaluation is typically needed to diagnose psychosis accurately. 

Schizophrenia Diagnosis 

There is no particular test that can be used to diagnose schizophrenia. If you or someone you love is exhibiting symptoms of schizophrenia, you should contact your healthcare provider as soon as you can.

The diagnostic criteria for schizophrenia include the following requirements:

  • Experiencing positive symptoms of psychosis for more than a month 
  • Experiencing a significant decline in functioning
  • Having symptoms that have been present over six months
  • Ruling out factors such as substance abuse and other mental health conditions

Psychosis and Schizophrenia Treatment

The most effective treatment for mental health conditions and their symptoms typically involves psychotherapy and medication. 

Psychosis Treatment

When a mental health condition brings on psychosis, doctors typically focus on treating symptoms of the condition as a whole.

A combination of medication and psychotherapy is the usual route. Antipsychotics like Risperdal (risperidone), Zyprexa (olanzapine), and Abilify (aripiprazole) are often used to treat symptoms of psychosis.

Schizophrenia Treatment

Schizophrenia is a lifelong condition. Unfortunately, there’s currently no cure for the disorder. Treatment focuses on managing your symptoms and improving your daily functioning. A combination of medication and therapy is also used to treat schizophrenia:

Prevention 

Although it may not be possible to prevent schizophrenia or certain types of psychosis, early recognition, treatment, and minimization of potential triggers (such as substances) are important.

Recap

  • Schizophrenia is a mental health condition that can cause psychosis. However, positive symptoms of psychosis are not always present over the course of the illness.
  • Psychosis is a symptom of many mental health and some medical conditions. It can also be caused by certain types of trauma, substance use, and brain injuries.
  • Diagnosis and treatment for both typically involve a combination of medication and psychotherapy.
  • The most distinguishable difference between psychosis and schizophrenia is that while psychosis is one of the symptoms of schizophrenia, schizophrenia is a mental health condition that causes psychosis, among other symptoms.

A Word From Verywell 

Psychosis and schizophrenia are both conditions that need expert care. If you or someone you love is experiencing symptoms of either condition, it’s essential to contact your healthcare provider as soon as you can. Knowing the difference between both conditions allows you to better understand the diagnosis, prognosis, and treatment.

13 Sources
Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. National Alliance on Mental Illness. Early psychosis and psychosis.

  2. National Institute of Mental Health (NIMH). Schizophrenia. 2021

  3. National Institute of Mental Health (NIMH). Understanding Psychosis.

  4. Gaebel W, Zielasek J. Focus on psychosis. Dialogues in Clinical Neuroscience. 2015;17(1):9.

  5. Ham S, Kim TK, Chung S, Im HI. Drug abuse and psychosis: new insights into drug-induced psychosis. Experimental Neurobiology. 2017;26(1):11.

  6. Fujii D, Ahmed I. Psychotic disorder following traumatic brain injury: a conceptual framework. Cognitive Neuropsychiatry. 2002;7(1):41-62.

  7. Cleveland Clinic. Schizophrenia.

  8. Karlsgodt KH, Sun D, Cannon TD. Structural and Functional Brain Abnormalities in SchizophreniaCurrent Directions in Psychological Science. 2010;19(4):226-231.

  9. Corcoran C, Mujica-Parodi L, Yale S, Leitman D, Malaspina D. Could stress cause psychosis in individuals vulnerable to schizophrenia?CNS Spectr. 2002;7(1):33-42.

  10. Winklbaur B, Ebner N, Sachs G, Thau K, Fischer G. Substance abuse in patients with schizophreniaDialogues Clin Neurosci. 2006;8(1):37-43. doi:10.31887/DCNS.2006.8.1/bwinklbaur

  11. Substance Abuse and Mental Health Services Administration. Impact of the DSM-IV to DSM-5 Changes on the National Survey on Drug Use and Health. Rockville (MD): Substance Abuse and Mental Health Services Administration (US); 2016 Jun

  12. Tamminga CA, Lahti AC. Treatments for chronic psychosis. Dialogues Clin Neurosci. 2001;3(4):281-292.

  13. Stankewicz HA, Richards JR, Salen P. Alcohol-related psychosis. In: StatPearls. StatPearls Publishing; 2022.

Toketemu Ohwovoriole

By Toketemu Ohwovoriole
Toketemu has been multimedia storyteller for the last four years. Her expertise focuses primarily on mental wellness and women’s health topics.