Characters who suffer from extreme psychosis (not at all to be confused with psychopathy; which are in fact, opposites). Psychosis itself is not an actual condition but rather a symptom of many other illnesses, the most common conditions associated with high-levels of psychosis include dissociative disorders and schizophrenia. Psychosis can also be caused by drug or alcohol abuse and people who suffer from psychotic conditions often become more violent or unstable if they engage in drug and/or alcohol misuse.

Psychotics are insane, having little to no understanding of what they are exactly doing or the severity of their actions; to qualify as a psychotic, a character must be shown to have the following patterns in most media they appear in:

• False beliefs: Psychotics will hold false beliefs that are nevertheless seen as fact, this means they often see the world in a very different manner to others and may hallucinate a wide array of phenomena. This makes them often appear to exist in their own world.
• Unpredictable behavior: Due to lacking an understanding of reality versus fiction, many psychotics will have extremely unpredictable behavior, this can be seen as one of the key differences between psychosis and psychopathy. While psychopaths can control their behaviors, a psychotic can not, thus they are much more notably ill and would be classed as "insane" in most settings.

IMPORTANT: Do not use this category for any and all "mentally ill " villains, only use it for characters who display all the signs and symptoms of someone who is suffering extreme psychosis, for any ill-defined or otherwise questionable behaviors that do not fall under extreme psychosis, use "Mentally Ill". In fact, do not add the psychotic, mentally ill or dissociative categories on the same villain as the three categories are different types of mental illnesses and adding them all on the same page would be redundant.

Psychotic villains can be tragic, since many of these types of characters can barely understand what they are doing and suffering from immense psychosis on a daily basis can be considered a sympathetic factor as these villains suffer with mental health and hardly understand what they do.

Either way, psychotic villains can qualify as Pure Evil if they have zero redeeming qualities or sympathetic traits and manage to hit all the criteria and possess a clear moral agency, even in spite of their psychosis (e.g. Kefka Palazzo, many versions of Joker, Frank Booth, Patrick Bateman, Jerome Valeska, Jeremiah Valeska and Cale Erendreich).

While not always the case, a good way to tell a psychopath from a psychotic is an old saying of "cold-blooded psychopath, hot-headed sociopath". In other words, a psychopath is cold, calculating and in control of their actions while a psychotic sociopath is unable to control their actions or emotions, this is why psychopaths are much better at hiding their aggression or violence while most psychotics are incapable of doing so and are thus much, much less capable of blending in with mainstream society.

Of course, not all sociopaths are psychotic. Simply having extreme mood swings is not enough to be classed as suffering psychosis unless it is accompanied by strange behaviors and beliefs, often of a paranoid, delusion or misanthropic nature. If left unchecked, these can lead to violence towards themselves or others.. if in doubt please do not attempt to "self-diagnose" a character, put them under "Mentally Ill" unless they are specifically said to suffer from, or exhibit all the signs of, a specific disorder.

Also, a psychopath/sociopath will NEVER fall under this category because they are always aware of reality, are in control of their own actions and are extremely calculating and intelligent while a psychotic is never in control of their own actions and are not aware of reality (though psychotics can’t be judged by our systems much like barbarians as the formers may also be intelligent enough to hit the Mastermind category.)