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Psychosis

Psychosis is a loss of contact with reality that usually includes:

  • False beliefs about what is taking place or who one is (delusions)
  • Seeing or hearing things that aren't there (hallucinations)

Causes, incidence, and risk factors

A number of medical problems can cause psychosis, including:

Psychosis (or psychotic symptoms) may also be found in:

Symptoms

Psychotic symptoms may include:

  • Disorganized thought and speech
  • False beliefs that are not based in reality (delusions), especially unfounded fear or suspicion
  • Hearing, seeing, or feeling things that are not there (hallucinations )
  • Thoughts that "jump" between unrelated topics (disordered thinking)

Signs and tests

Psychiatric evaluation and testing are used to diagnose the cause of the psychosis.

Laboratory testing and brain scans may not be needed, but sometimes can help pinpoint the diagnosis. Tests may include:

  • Blood tests for abnormal electrolyte and hormone levels
  • Blood tests for syphilis and other infections
  • Drug screens
  • MRI of the brain

Treatment

Treatment depends on the cause of the psychosis. Care in a hospital is often needed to ensure the patient's safety.

Antipsychotic drugs, which reduce hallucinations and delusions and improve thinking and behavior are helpful, whether the cause is a medical or psychiatric disorder.

See: Schizophrenia for more information about the treatment of psychosis.

Expectations (prognosis)

How well a person does depends on the cause of the psychosis. If the cause can be corrected, the outlook is often good, and treatment with antipsychotic medication may be brief.

Some chronic conditions, such as schizophrenia, may need life-long treatment with antipsychotic medications to control symptoms.

Complications

Psychosis can prevent people from functioning normally and caring for themselves. If the condition is left untreated, people can sometimes harm themselves or others.

Calling your health care provider

Call your health care provider or mental health professional if you or a member of your family is losing contact with reality. If there is any concern about safety, immediately take the person to the nearest emergency room to be seen by a doctor.

Prevention

Prevention depends on the cause. For example, avoiding alcohol abuse prevents alcohol-induced psychosis.

References

Freudenreich O, Weiss AP, Goff DC. Psychosis and schizophrenia. In: Stern TA, Rosenbaum JF, Fava M, Biederman J, Rauch SL, eds. Massachusetts General Hospital Comprehensive Clinical Psychiatry. 1st ed. Philadelphia, Pa: Mosby Elsevier; 2008:chap 28.

Updated: 3/7/2012

Fred K. Berger, MD, Addiction and Forensic Psychiatrist, Scripps Memorial Hospital, La Jolla, California. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.


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