The Pathway to Psychosis

“How all occasions do inform against me” is a line from act IIII, scene IIII of

William Shakespeare’s Hamlet. This line, spoken by Hamlet, expresses his emotional state as he

is currently overwhelmed by the death of his father, the king of Denmark, and the situation

surrounding it. After Hamlet learns of his father’s death he finds out that his mother has married

Claudius, Hamlet’s uncle. On top of all of that, Hamlet soon after discovers that Claudius

murdered his father in order to become king, and he takes it upon himself to avenge his

father’s death. Throughout the play, the severe stress of the situation seems to take its toll on

Hamlet putting him in a depressed state, and eventually over time he grows ‘mad’. To put in

psychological terms, he developed psychosis. The question that this paper will address is how an

individual develops psychosis? There is a wide range of theories, all with reasonable evidence. It

These different theories seem to indicate that psychosis is the result of a recipe of different

environmental, biological, and neural structural factors.

An environmental factor that appears to play a part in the development of psychosis is

stress. A study published in the European Archives of Psychiatry and Clinical Neuroscience

journal entitled Reappraisal of the interplay between psychosis and depression symptoms in the

pathogenesis of psychotic syndromes: results from a twenty-year prospective community study

examines the relationship between psychosis and depression symptoms in the onset of psychosis,

using evidence from the Zurich study (Rossler, et al., 2011, pp. 11-13). The 20 yearlong study,

which was conducted in Switzerland, involved...

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...n Os , J., & Myin-Germeys, I. (2011). Childhood trauma and increased stress. ACTA PSYCHIATRICA, 28–35.

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Rossler, W., Angst, J., Gamma, A., Haker, H., Stulz, N., Merikangas, K. R., & Ajdacic-Gross, V. (2011). Reappraisal of the interplay between psychosis and depression. Eur Arch Psychiatry Clin Neurosci , 11-19.

Stefanis, N. C., Henquet, C., Avramopoulos, D., Smyrnis, N., Evdokimidis, I., Germeys, I. M., . . . Os, J. V. (2007). COMT Val158Met moderation of stress-induced psychosis. Psychological Medicine, 1651–1656.

Thompson, J. L., Pogue-Geile, M. F., & Grace , A. A. (2004). Developmental Pathology, Dopamine, and Stress: A Model for the Age of Onset of Schizophrenia Symptoms. Schizophrenia Bulletin, 875-900.