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Psychosis

For other uses, see Psychosis (disambiguation).
Not to be confused with Psychopathy.
Psychosis
Other namesPsychotic break (colloquial)
SpecialtyPsychiatry, clinical psychology
SymptomsFalse beliefs, seeing or hearing things that others do not see or hear, incoherent speech and behavior[1]
ComplicationsSelf-harm, suicide[2]
CausesMental illness (schizophrenia, bipolar disorder), trauma, sleep deprivation, some medical conditions, certain medications, drugs (including alcohol, caffeine and cannabis)[1]
TreatmentAntipsychotics, counselling, social support[2]
PrognosisDepends on cause[2]
Frequency3% of people at some point in their life (US)[1]

Psychosis is a condition of the mind that results in difficulties determining what is real and what is not real.[3] Symptoms may include delusions and hallucinations, among other features.[3] Additional symptoms are incoherent speech and behavior that is inappropriate for a given situation.[3] There may also be sleep problems, social withdrawal, lack of motivation, and difficulties carrying out daily activities.[3] Psychosis can have serious adverse outcomes.[3]

As with many psychiatric phenomena, psychosis has several different causes.[4] These include mental illness, such as schizophrenia or schizoaffective disorder, bipolar disorder, sensory deprivation,[5] Wernicke-Korsakoff syndrome or cerebral beriberi[6] 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.[7] One type, known as postpartum psychosis, can occur after giving birth.[8] The neurotransmitter dopamine is believed to play an important role.[9][10] Acute psychosis is termed primary if it results from a psychiatric condition and secondary if it is caused by another medical condition or drugs.[11] The diagnosis of a mental-health condition requires excluding other potential causes.[12] Testing may be done to check for central nervous system diseases, toxins, or other health problems as a cause.[13]

Treatment may include antipsychotic medication, psychotherapy, and social support.[1][2] Early treatment appears to improve outcomes.[1] Medications appear to have a moderate effect.[14][15] Outcomes depend on the underlying cause.[2] In the United States about 3% of people develop psychosis at some point in their lives.[1] 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.[16][17]

  1. ^ a b c d e f "RAISE Questions and Answers". NIMH. Archived from the original on 8 October 2019. Retrieved 23 January 2018.
  2. ^ a b c d e "Psychosis". NHS. 23 December 2016. Archived from the original on 15 October 2018. Retrieved 24 January 2018.
  3. ^ a b c d e Arciniegas DB (June 2015). "Psychosis". Continuum. 21 (3 Behavioral Neurology and Neuropsychiatry): 715–736. doi:10.1212/01.CON.0000466662.89908.e7. PMC 4455840. PMID 26039850.
  4. ^ Radua J, Ramella-Cravaro V, Ioannidis JP, Reichenberg A, Phiphopthatsanee N, Amir T, et al. (February 2018). "What causes psychosis? An umbrella review of risk and protective factors". World Psychiatry. 17 (1): 49–66. doi:10.1002/wps.20490. PMC 5775150. PMID 29352556.
  5. ^ Gelder, Michael G.; Gath, Dennis; Mayou, Richard (1983). Oxford Textbook of Psychiatry. Oxford University Press. ISBN 978-0-19-261294-6.
  6. ^ "Korsakoff Psychosis - Special Subjects". MSD Manual Professional Edition. Retrieved 2024-04-10.
  7. ^ Griswold KS, Del Regno PA, Berger RC (June 2015). "Recognition and Differential Diagnosis of Psychosis in Primary Care". American Family Physician. 91 (12): 856–863. PMID 26131945. Archived from the original on 2021-02-22. Retrieved 2021-12-06.
  8. ^ Davies W (June 2017). "Understanding the pathophysiology of postpartum psychosis: Challenges and new approaches". World Journal of Psychiatry. 7 (2): 77–88. doi:10.5498/wjp.v7.i2.77. PMC 5491479. PMID 28713685.
  9. ^ Stahl SM (June 2018). "Beyond the dopamine hypothesis of schizophrenia to three neural networks of psychosis: dopamine, serotonin, and glutamate". CNS Spectrums. 23 (3): 187–191. doi:10.1017/S1092852918001013. PMID 29954475. S2CID 49599226.
  10. ^ Grace AA (August 2016). "Dysregulation of the dopamine system in the pathophysiology of schizophrenia and depression". Nature Reviews. Neuroscience. 17 (8): 524–532. doi:10.1038/nrn.2016.57. PMC 5166560. PMID 27256556.
  11. ^ Griswold KS, Del Regno PA, Berger RC (June 2015). "Recognition and Differential Diagnosis of Psychosis in Primary Care". American Family Physician. 91 (12): 856–863. PMID 26131945.
  12. ^ Cardinal RN, Bullmore ET (2011). The Diagnosis of Psychosis. Cambridge University Press. p. 279. ISBN 978-1-139-49790-9. Archived from the original on 2020-08-06. Retrieved 2020-06-25.
  13. ^ Foster NL (2011). The American Psychiatric Publishing Textbook of Geriatric Neuropsychiatry. American Psychiatric Pub. p. 523. ISBN 978-1-58562-952-7. Archived from the original on 2020-08-19. Retrieved 2020-06-25.
  14. ^ Haddad PM, Correll CU (November 2018). "The acute efficacy of antipsychotics in schizophrenia: a review of recent meta-analyses". Therapeutic Advances in Psychopharmacology. 8 (11): 303–318. doi:10.1177/2045125318781475. PMC 6180374. PMID 30344997.
  15. ^ Leucht S, Leucht C, Huhn M, Chaimani A, Mavridis D, Helfer B, et al. (October 2017). "Sixty Years of Placebo-Controlled Antipsychotic Drug Trials in Acute Schizophrenia: Systematic Review, Bayesian Meta-Analysis, and Meta-Regression of Efficacy Predictors". The American Journal of Psychiatry. 174 (10): 927–942. doi:10.1176/appi.ajp.2017.16121358. PMID 28541090. S2CID 27256686.
  16. ^ Gibbs RS (2008). Danforth's Obstetrics and Gynecology. Lippincott Williams & Wilkins. p. 508. ISBN 978-0-7817-6937-2.
  17. ^ Giddens JF (2015). Concepts for Nursing Practice - E-Book. Elsevier Health Sciences. p. 348. ISBN 978-0-323-38946-4. Archived from the original on 2020-08-19. Retrieved 2020-06-25.

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