Psychosis

For other uses, see Psychosis (disambiguation).
Not to be confused with Psychopathy.
Psychosis
Other namesPsychotic break (colloquial)
SpecialtyPsychiatry, clinical psychology
Symptomsdelusions, hallucinations, 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 or psyche 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 disorganized thinking and 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]

Psychosis can have 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.[7] The diagnosis of a mental-health condition requires excluding other potential causes.[11] Testing may be done to check for central nervous system diseases, toxins, or other health problems as a cause.[12]

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.[13][14] 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.[15][16]

  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. ^ a b 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. ^ 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.
  12. ^ 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.
  13. ^ 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.
  14. ^ 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.
  15. ^ Gibbs RS (2008). Danforth's Obstetrics and Gynecology. Lippincott Williams & Wilkins. p. 508. ISBN 978-0-7817-6937-2.
  16. ^ 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.