Psychosis vs. Psychopathy (And Other Psych Terms)

There’s a lot of overlap in terms used in psychiatry/psychology-speak, and sometimes that can lead to the mistaken association of words that contain some of the same parts but actually mean very different things (like psychosis and psychopathy). This post will break down some of those words and word roots to hopefully add some clarity.

Word roots

20 years ago, when I was in pharmacy school (yes, I’m old), I was required to take a classical studies course that covered Greek and Latin words that were used as roots in medical (including psychiatric) language. Here are some relevant bits.

Prefixes

• a-/an-: not/without – this one shows up in a lot of terms
• affect-: mood
• anti-: against
• hallucin-: wandering mind
• intro-/extro-: inward/outward
• patho-: disease
• psych-: pertaining to the mind, from psyche (breath/life/soul)
• schizo-: split

Suffixes

• -al: pertaining to
• -ation: process
• -iatry: denotes a medical field
• –logy: study of ___
• -oid: resembling
• -osis: abnormal condition, disease (-otic is the adjective form of this)
• -pathy: a negative condition or a disorder, from pathos (suffering)
• -phrenia: mind (specifically, the source of thought)
• -version: turning

Mental illness

• Schizophrenia (schizo-phrenia): thinking mind split, in the sense of split from reality, not split personality
• Schizoaffective disorder (schizo-affect-ive): schizophrenia (the -phrenia is implied) mood disorder, i.e. schizophrenia with major depression or bipolar superimposed on top of it

• Pathological (patho-logic-al): pertaining to the study of disorders; it can be used to describe a normal experience that has become disordered, such as pathological grief
• Psychopathology (psycho-patho-logy): mind disorder study, or the presence of some sort of mental disorder, including any form of mental illness; while “psychopath” is part of the word, there’s nothing about the term psychopathology that’s specifically related to psychopathy.

Psychiatric symptoms

• Anhedonia (an-hedonia): without pleasure

• Hallucination (hallucin-ation): wandering mind process, used to describe distorted sensory perceptions
• Psychosis (psych-osis): abnormal condition of the mind, which specifically involves delusions, hallucinations, and/or grossly disorganized thinking
  • this is a group of symptoms, not a diagnosis, and can occur in primary psychotic disorders like schizophrenia, but also mood disorders (bipolar and depression) and other disorders
  • psychosis on its own doesn’t increase the risk of violence, with the specific exception being people who experience command auditory hallucinations to harm others
  • psychotic: someone experiencing psychosis

• Psychomotor retardation (psycho-motor retard-ation): mind-movement slowing process; can be a symptom of depression

Personality, personality disorders

• Asocial (a-social): not social
• Antisocial (anti-social): against social rules/norms/customs
• Introversion/extroversion (intro-/extro-version): inward or outward turning

• Antisocial (anti-social) personality disorder: a personality disorder in the DSM, characterized by going against social rules, including law-breaking, with an elevated risk for violence
• Sociopathy (socio-pathy): social disorder; a previous name for antisocial personality disorder, but sometimes used colloquially to refer to psychopathy
• Psychopathy (psycho-pathy): mind disease
  • refers to a group of personality traits and behaviours, including lack of empathy and remorse, and frequent lying
  • not a diagnosis; the closest would be antisocial PD, but they’re not the same thing, and not everyone with antisocial PD is a psychopath, nor does everyone with high levels of psychopathy have a diagnosis of antisocial PD
  • subclinical psychopathy is used to describe a milder presentation of these traits
  • does not involve psychosis, and is unrelated to psychotic disorders like schizophrenia
  • some psychopaths are extremely violent, while others (like the idea of the corporate psychopath) are not

• Schizoid (schiz-oid) personality disorder: schizophrenia-resembling personality disorder
• Schizotypal (schizo-typal) personality disorder: schizophrenia-type personality disorder

Take-away message

The key thing is that just because some words have similar bits in them doesn’t mean they refer to the same thing.

In particular, I would like to shout from the rooftops that psychosis/psychotic and psychopathy/psychopathic have nothing whatsoever to do with each other.