Psychosis

Definition

Psychosis is the 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 chemicals and/or structures of the brain. Some conditions associated with psychosis include:

Psychological conditions such as schizophrenia , schizoaffective disorder , bipolar disorder , severe depression , and some personality disorders
Medical conditions such as HIV and AIDS , malaria , brain infections, some metabolic or neurologic conditions, including Alzheimer and Parkinson disease
Some medications, or abuse of alcohol or drugs such as cocaine, LSD, and methamphetamines

The Brain

Risk Factors

Factors that may increase your chance of psychosis include:

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

Symptoms

Symptoms can vary but may include:

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

Diagnosis

You will be asked about your symptoms and medical history. A physical exam will be done. Information about alcohol use, illegal drugs, prescription medications, supplements, and herbs will also be collected. A psychiatric evaluation will be done.

Bodily fluids may be tested to look for the presence of substances that can cause problems or to look for imbalance in the body. This can be done with:

Blood tests
Urine tests

Treatment

Treatment will depend on the cause of your psychosis. Talk with your doctor about the best treatment plan for you. Hospitalization may be needed until the psychosis is managed. Options may include one or more of the following:

Psychological Therapy

Psychological therapy treatments are often recommended in addition to medication. There are several different types of therapies such as:

Cognitive-behavioral therapy to change unhelpful thinking patterns
Family therapy to help your family cope with your condition and identify signs that you may need additional help such as wandering or self harm
Support groups to talk to others who have had similar experiences

The medical team will help determine which therapy or therapies may be best.

Medications

Medications may be recommended to control symptoms. The exact type or combination will depend on symptoms and causes. Some options include:

Antipsychotic medications—to change the action of certain chemicals in the brain and control abnormal thinking
Antidepressants
Anti-anxiety medications
Mood stabilizers

Prevention

Prevention depends on the cause of psychosis. Those at risk for psychosis may be able to prevent a psychotic episode with careful management of related condition.

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

Olin SC, Mednick SA. Risk factors of psychosis: identifying vulnerable populations premorbidly. Schizophr Bull. 1996;22(2):223-240.

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 October 4, 2017.

Psychosis. NHS Choices website. Available at: http://www.nhs.uk/Conditions/Psychosis/Pages/Introduction.aspx. Updated December 23, 2016. Accessed October 4, 2017.

Psychosis. Rethink Mental Illness website. Available at: https://www.rethink.org/diagnosis-treatment/conditions/psychosis. Updated February 2016. Accessed October 4, 2017.

What is early and first-episode psychosis? National Alliance on Mental Illness website. Available at: https://www.nami.org/getattachment/Learn-More/Mental-Health-Conditions/Early-Psychosis-and-Psychosis/NAMI-Early-Psychosis.pdf. Accessed October 4, 2017.

Revision Information

Reviewer: EBSCO Medical Review Board Adrian Preda, MD
Review Date: 09/2018
Update Date: 10/13/2015

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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.