Cognition and Psychosis2023-05-14

A hallucination is a fact, not an error; what is erroneous is a judgment based upon it.

—Bertrand Russell

Cognition is connectivity, the ability to connect the dots between perception of events in the internal milieu and external environment, and the appropriate responses to them. It is the result of learning of past generations, reflected in your genes, and of your own learnings, reflected in the development and architecture of your brain. Cognition is the basis of intelligence.

Disruptions in cognition have to do with sensory aspects, motor aspects, and conceptual aspects. Excess of those functions are known as positive symptoms, paucity of those functions are known as negative symptoms. The prototypical clinical disorder is schizophrenia. Sensory disruptions lead to excessive or odd sensory signal (hallucinations) or lack of input (sensory integration disorder). Motor disruptions lead to excessive or odd behaviors (disorganized behavior) or lack of behavior (catatonia). Conceptual disruptions lead to excessive or odd thoughts (delusions) or lack of thoughts (thought blocking).

We have developed a simple four items quantitative assessment of psychosis, called Simplified Psychosis Scale (SPS4), that is deployed inside our Life x Mind app. We are also working on a blood test for hallucinations and one for delusions. Those are the most pathognomonic manifestations of psychosis. The app and blood tests will help clinicians with the diagnostic assessment, and the blood tests will permit matching patients to the right medications, reducing the usual trial and error process. Stay tuned, the work is being written up for publication.

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