What are the core features of psychosis?

• A. A syndrome with delusions, hallucinations, disorganized thinking/speech, and impaired reality testing.
• B. A mood disturbance with elevated energy
• C. A mild cognitive impairment
• D. A dissociative state without memory loss

Answer: (B)

Psychosis involves a break from reality, most clearly shown by delusions, hallucinations, disorganized thinking or speech, and difficulty distinguishing what is real from what is not. Delusions are fixed false beliefs that remain despite contrary evidence. Hallucinations are sensory experiences—often auditory—that occur without a real external stimulus. Disorganized thinking or speech appears as incoherent or tangential speech. Impaired reality testing means a diminished ability to tell thoughts or internal experiences from what’s happening in the outside world. These features tend to appear together in psychotic disorders such as schizophrenia and related conditions. The other options describe different phenomena: a mood disturbance with elevated energy signals a manic state, mild cognitive impairment concerns cognitive decline without psychosis, and a dissociative state with memory loss centers on identity or memory disruption rather than primary psychotic symptoms.