• 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:
    The Brain
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    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: 09/2017
    • Update Date: 10/13/2015
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