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Jai Ganesh

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Registered: 2005-06-28

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Psychosis

Psychosis

Gist

Psychosis refers to a collection of symptoms that affect the mind, where there has been some loss of contact with reality. During an episode of psychosis, a person's thoughts and perceptions are disrupted and they may have difficulty recognizing what is real and what is not.

Summary

Psychosis occurs when a person loses contact with reality. The person may:

* Have false beliefs about what is taking place, or who one is (delusions)
* See or hear things that are not there (hallucinations)

Causes

Medical problems that can cause psychosis include:

* Alcohol and certain illegal drugs, both during use and during withdrawal
* Brain diseases, such as Parkinson disease and Huntington disease
* Brain tumors or cysts
* Dementia (including Alzheimer disease)
* HIV and other infections that affect the brain
* Some prescription drugs, such as steroids and stimulants
* Some types of epilepsy
* Stroke

Psychosis may also be found in:

* Most people with schizophrenia
* Some people with bipolar disorder (manic-depressive) or severe depression
* Some personality disorders

Symptoms

A person with psychosis may have any of the following:

* Disorganized thought and speech
* False beliefs that are not based on 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)

Exams 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 person's safety.

Antipsychotic drugs, which reduce hallucinations and delusions and improve thinking and behavior, are helpful.

Outlook (Prognosis)

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

Some chronic conditions, such as schizophrenia, may need lifelong treatment with antipsychotic drugs to control symptoms.

Possible Complications

Psychosis can prevent people from functioning normally and caring for themselves. Left untreated, people can sometimes harm themselves or others.

When to Contact a Medical Professional

Contact 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, take the person to the emergency room to be seen by a doctor.

Prevention

Prevention depends on the cause. For example, avoiding alcohol prevents psychosis caused by alcohol use.

Details

The exact cause of psychosis isn’t always clear. It’s important to seek help if you experience hallucinations, delusions, or trouble thinking clearly. Most people recover with treatment, such as therapy and medication.

Psychosis is a combination of symptoms resulting in an impaired relationship with reality. It can be a symptom of serious mental health disorders. People who are experiencing psychosis may have either hallucinations or delusions.

Hallucinations are sensory experiences that occur within the absence of an actual stimulus. For example, a person having an auditory hallucination may hear their mother yelling at them when their mother isn’t around. Or someone having a visual hallucination may see something, like a person in front of them, who isn’t actually there.

The person experiencing psychosis may also have thoughts that are contrary to actual evidence. These thoughts are known as delusions. Some people with psychosis may also experience loss of motivation and social withdrawal.

These experiences can be frightening. They may also cause people who are experiencing psychosis to hurt themselves or others.

It’s important to get medical help right away if you or someone else is experiencing symptoms of psychosis.

Recognizing the symptoms of psychosis

According to the National Institute for Mental Health (NIMH)Trusted Source, there are warning signs that may appear before psychosis develops. These can include:

* a sudden drop in school work or job performance
* trouble thinking clearly
* difficulty concentrating
* feeling paranoid or suspicious of others
* withdrawing from friends and loved ones
* an influx of strange, new feelings, or no feeling at all
* a disinterest in personal grooming
* difficulty separating reality from non-reality
* trouble communicating

If someone is experiencing an episode of psychosis, the main symptoms include:

* hallucinations
* delusions
* disorganized behavior (behavior that does not seem to make sense, or that is impulsive)
* negative symptoms (seemingly having no emotion, lack of interest in activities previously enjoyed, an ungroomed appearance, etc.)
* catatonia (a “frozen” appearance)

Confused and disturbed thoughts

A person who is experiencing psychosis may often have confusing and disrupted thoughts. Some examples of this include:

* constant talking with rapid speech patterns
* switching topics mid-sentence with no explanation
* a sudden loss of their train of thought, causing them to pause or freeze abruptly

What are delusions and hallucinations?

Delusions and hallucinations are two very different symptoms that are both often experienced by people with psychosis. Delusions and hallucinations seem real to the person who is experiencing them.

Delusions

A delusion is a false belief or impression that is firmly held even though it’s contradicted by reality and what is commonly considered true. There are delusions of paranoia, grandiose delusions, and somatic delusions.

People who are experiencing a delusion of paranoia might think that they are being followed when they’re not, or that secret messages are being sent to them.

Someone with a grandiose delusion will have an exaggerated sense of importance.

Somatic delusion is when a person believes they have a terminal illness, but in reality they’re healthy.

Hallucinations

A hallucination is a sensory perception in the absence of outside stimuli. That means seeing, hearing, feeling, or smelling something that isn’t present.

A person who is hallucinating might see things that don’t exist or hear people talking when they’re alone.

Causes of psychosis

Each case of psychosis is different, and the exact cause isn’t always clear. There are certain illnesses that cause psychosis. There are also triggers like drug use, lack of sleep, and other environmental factors. In addition, certain situations can lead to specific types of psychosis developing.

In general, some of the factors involved in psychosis are:

* genetics
* trauma (such as a death, sexual assault, or living through a war)
* substance use (drugs like LSD and amphetamines have been linked to instances of psychosis in some people)
* mental health conditions (like schizophrenia)

Risk factors for developing psychosis

It’s not currently possible to precisely identify who is likely to develop psychosis. However, research has shown that genetics may play a role.

People are more likely to develop a psychotic disorder if they have a close family member, such as a parent or sibling, who has a psychotic disorder.

Additional Information

Psychosis is a condition of the mind that results in difficulties determining what is real and what is not real. Symptoms may include delusions and hallucinations, among other features. Additional symptoms are incoherent speech and behavior that is inappropriate for a given situation. There may also be sleep problems, social withdrawal, lack of motivation, and difficulties carrying out daily activities. Psychosis can have serious adverse outcomes.

As with many psychiatric phenomena, psychosis has several different causes. These include mental illness, such as schizophrenia or schizoaffective disorder, bipolar disorder, sensory deprivation, and in rare cases major depression (psychotic depression). Other causes include: trauma, sleep deprivation, some medical conditions, certain medications, and drugs such as alcohol, cannabis, hallucinogens, and stimulants. One type, known as postpartum psychosis, can occur after giving birth. The neurotransmitter dopamine is believed to play an important role. Acute psychosis is termed primary if it results from a psychiatric condition and secondary if it is caused by another medical condition or drugs. The diagnosis of a mental-health condition requires excluding other potential causes. Testing may be done to check for central nervous system diseases, toxins, or other health problems as a cause.

Treatment may include antipsychotic medication, psychotherapy, and social support. Early treatment appears to improve outcomes. Medications appear to have a moderate effect. Outcomes depend on the underlying cause. In the United States about 3% of people develop psychosis at some point in their lives. The condition has been described since at least the 4th century BC by Hippocrates and possibly as early as 1500 BC in the Egyptian Ebers Papyrus.

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