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 medicalproblems can cause psychosis, including:
Alcoholand certain illegal drugs, both during use and during withdrawal
- Brain diseases, such as
Parkinson's disease, Huntington's disease, and certain chromosomal disorders
- Brain tumors or cysts
Dementia(including Alzheimer's disease)
- HIV and other infections that affect the brain
- Some prescription drugs, such as steroids and stimulants
- Some types of
Psychosis (or psychotic symptoms) may also be foundin:
- Most people with
- Some people with
bipolar disorder(manic-depressive) or severe depression
- Some personality disorders
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 (
- 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
electrolyteand hormone levels
- Blood tests for syphilis and other infections
- Drug screens
MRIof the brain
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.
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.
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 depends on the cause. For example, avoiding alcohol abuse prevents alcohol-induced psychosis.
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.