Psychosis

Definition

Psychosis is loss of contact with reality. It may result in false beliefs called delusions or sensing things that are not really there (hallucinations).

Causes

Psychosis may be caused by changes in brain chemicals or structures. It can occur with:

Psychological conditions such as
- Schizophrenia and schizoaffective disorder
- Bipolar disorder, severe depression, and some personality disorders
Medical problems such as:
- HIV and AIDS, malaria, and brain infections
- Alzheimer and Parkinson disease
Some medicines, or abuse of alcohol or illegal drugs

The Brain

Risk Factors

Things that may raise the risk of psychosis are:

A family history of severe mental illness
Brain problems
Problems during pregnancy or birth
Loss of parent during childhood
Poor family functioning
Substance abuse

Symptoms

Symptoms can vary. They may include:

Hallucinations—hearing, seeing, smelling, tasting, or feeling things that are not there
Delusions—unusual or false beliefs
Confusion
Sudden changes in mood or odd behavior

Diagnosis

The doctor will ask about your symptoms and health history. A physical exam will be done. The doctor will ask about use of substances. This includes alcohol use, illegal drugs, medicines, supplements and herbs. A mental health exam will be done.

Blood and urine tests will be done. This is to check for substances or imbalances in the body.

Treatment

Treatment of psychosis depends on the cause. Hospital care may be needed until the condition is managed. Options may be:

Counseling, such as cognitive-behavioral therapy—to help with coping
Family therapy—to help the family cope
Support groups—to talk to others with similar problems
Medicines, such as:
- Antipsychotics—to reduce abnormal thinking
- Antidepressants
- Antianxiety medicines
- Mood stabilizers

Prevention

Preventing psychosis depends on the cause. Certain conditions raise the risk. Managing those conditions may reduce it.

RESOURCES

National Institute of Mental Health
https://www.nimh.nih.gov

National Mental Health Association
http://www.mentalhealthamerica.net

CANADIAN RESOURCES

Canadian Mental Health Association
https://cmha.ca

Canadian Psychiatric Association
http://www.cpa-apc.org

References

Ahsan MS, Mullick MS, et al. Substance use among the patients with first episode psychosis. Mymensingh Med J. 2018;27(2):313-320.

First psychosis–approach to the patient. EBSCO DynaMed website. Available at: https://www.dynamed.com/approach-to/first-episode-psychosis-approach-to-the-patient. Accessed March 12, 2021.

Psychosis. Centre for Addiction and Mental Health website. Available at: http://www.camh.ca/en/hospital/health%5Finformation/a%5Fz%5Fmental%5Fhealth%5Fand%5Faddiction%5Finformation/psychosis/Pages/Psychosis.aspx. Accessed March 12, 2021.

Psychosis. National Alliance on Mental Illness website. Available at: https://www.nami.org/About-Mental-Illness/Mental-Health-Conditions/Psychosis Accessed March 12, 2021.

Psychosis. NHS Choices website. Available at: http://www.nhs.uk/Conditions/Psychosis/Pages/Introduction.aspx. Accessed March 12, 2021.

Psychosis. Rethink Mental Illness website. Available at: https://www.rethink.org/diagnosis-treatment/conditions/psychosis. Accessed March 12, 2021.

Revision Information

Reviewer: EBSCO Medical Review Board Adrian Preda, MD
Review Date: 01/2021
Update Date: 03/12/2021

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This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.