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Editorial: August-2023

American Psychiatric Association refers psychosis to mental conditions with gross impairment in reality testing interfering with daily life-styles. It involves disruptive functions connected with neurodevelopment and neurological conditions. The current approaches also involve the schizophrenia disorders. Delusions, hallucinations and disorders of thought most relevant features. A systematic review and meta-analysis study published in JAMA Psychiatry on 12th July noted around 6% patients with psychosis have clinically relevant radiological abnormalities on magnetic resonance imaging (MRI). Other studies have mentioned about the consistent reduction in temporoinsular, anterior and cerebellar gray matter reduction in case of psychosis. However, many other reasons are suggested depending upon the types of psychosis as substance induced, hormonal changes (postpartum psychosis) etc. Trigger may be anything disturbing normal physiology of brain resulting in specific symptoms. Dopamine, gluatamate, serotonin etc. are neurotransmitters directly connected with psychosis by various complex networking involving adrenal hormones. Insufficiency of these hormones results in hypocortisolemic conditions leading to psychosis. References of psychosis based on symptoms are noted in Ayurveda.

Charak Samhita refers to Unmada as mental disorder in connection with mind, intellect, memory, inclination etc. Symptoms of Unmada include insanity, mania, mental derangement etc. Pitta imbalance is primary cause. Over or under activities of Pitta results in imbalance of Tridosha reflecting in Unmada related symptoms. This further brings about the alteration of secretion of neurochemicals directly or indirectly. Detailed diagnosis with discernment of Pitta imbalance linked to effects on the neurochemicals and the normal structures and functions of different parts of brain is essential to study for scientific basis of these aspects. So, utilization of imaging techniques and neurochemical profile becomes important for appropriate diagnosis.