Psychosis

Definition

Psychosis is a loss of contact with reality, usually including false ideas about what is taking place or who one is (delusions) and seeing or hearing things that aren't there (hallucinations).

Alternative Names

Psychotic

Causes, incidence, and risk factors

Psychosis is a severe mental condition in which there is a loss of contact with reality. There are many possible causes:

• Alcohol and certain drugs
• Brain tumors
• Dementia (including Alzheimer's disease)
• Epilepsy
• Manic depression (bipolar disorder)
• Psychotic depression
• Schizophrenia
• Stroke

Symptoms

• Abnormal displays of emotion
• Confusion
• Depression and sometimes suicidal thoughts
• Disorganized thought and speech
• Extreme excitement (mania)
• False beliefs (delusions)
• Loss of touch with reality
• Mistaken perceptions (illusions)
• Seeing, hearing, feeling, or perceiving things that are not there (hallucinations)
• Unfounded fear/suspicion

Signs and tests

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

Laboratory and x-ray testing may not be needed, but sometimes can help pinpoint the exact diagnosis. Tests may include:

• Drug screens
• MRI of the brain
• Tests for syphilis

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 "hearing voices" (auditory hallucinations) and delusions, and control thinking and behavior are helpful. Group or individual therapy can also be useful.

Expectations (prognosis)

How well a person will do depends on the specific disorder. Long-term treatment can control many of the symptoms.

Complications

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

Calling your health care provider

Call your health care provider or mental health professional if a member of your family acts as though they have lost contact with reality. If there is any concern about safety, immediately take the person to the nearest emergency room to be checked.

Prevention

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

References

International Early Psychosis Association Writing Group. International clinical practice guidelines for early psychosis. Br J Psychiatry. 2005;187:s120-s124.

Addington D, Bouchard RH, Goldberg J, Honer B, Malla A, Norman R, Tempier R. Clinical practice guidelines: treatment of schizophrenia. Can J Psychiatry. 2005;50:7S-57S.