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Definition

Psychosis is 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 brain chemicals or structures. It can occur with:

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Risk Factors

Things that may raise the risk of psychosis are:

  • A family history of severe mental illness
  • Brain problems
  • Problems during pregnancy or birth
  • Loss of parent during childhood
  • Poor family functioning
  • Substance abuse

Symptoms

Symptoms can vary. They may include:

  • Hallucinations—hearing, seeing, smelling, tasting, or feeling things that are not there
  • Delusions—unusual or false beliefs
  • Confusion
  • Sudden changes in mood or odd behavior

Diagnosis

The doctor will ask about your symptoms and health history. A physical exam will be done. The doctor will ask about use of substances. This includes alcohol use, illegal drugs, medicines, supplements and herbs. A mental health exam will be done.

Blood and urine tests will be done. This is to check for substances or imbalances in the body.

Treatment

Treatment of psychosis depends on the cause. Hospital care may be needed until the condition is managed. Options may be:

  • Counseling, such as cognitive-behavioral therapy—to help with coping
  • Family therapy—to help the family cope
  • Support groups—to talk to others with similar problems
  • Medicines, such as:
    • Antipsychotics—to reduce abnormal thinking
    • Antidepressants
    • Antianxiety medicines
    • Mood stabilizers

Prevention

Preventing psychosis depends on the cause. Certain conditions raise the risk. Managing those conditions may reduce it.

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:

Ahsan MS, Mullick MS, et al. Substance use among the patients with first episode psychosis. Mymensingh Med J. 2018;27(2):313-320.

First psychosis–approach to the patient. EBSCO DynaMed website. Available at: https://www.dynamed.com/approach-to/first-episode-psychosis-approach-to-the-patient. Accessed March 12, 2021.

Psychosis. Centre for Addiction and Mental Health website. Available at: http://www.camh.ca/en/hospital/health_information/a_z_mental_health_and_addiction_information/psychosis/Pages/Psychosis.aspx. Accessed March 12, 2021.

Psychosis. National Alliance on Mental Illness website. Available at: https://www.nami.org/About-Mental-Illness/Mental-Health-Conditions/Psychosis Accessed March 12, 2021.

Psychosis. NHS Choices website. Available at: http://www.nhs.uk/Conditions/Psychosis/Pages/Introduction.aspx. Accessed March 12, 2021.

Psychosis. Rethink Mental Illness website. Available at: https://www.rethink.org/diagnosis-treatment/conditions/psychosis. Accessed March 12, 2021.

Last reviewed January 2021 by EBSCO Medical Review Board Adrian Preda, MD  Last Updated: 3/12/2021