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Psychosis

For other uses, see Psychosis (disambiguation).
Not to be confused with Psychopathy or Sycosis.
Psychosis
Other namesPsychotic break (colloquial)
SpecialtyPsychiatry, emergency medicine, 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]

In psychopathology, psychosis is a condition in which a person is unable to distinguish between what is and is not real.[3] Examples of psychotic symptoms are delusions, hallucinations, and disorganized or incoherent thoughts or speech.[3] Psychosis is a description of a person's state or symptoms, rather than a particular mental illness, and it is not related to psychopathy (a personality construct[4][5] characterized by impaired empathy and remorse, along with bold, disinhibited, and egocentric traits).

Common causes of chronic (i.e. ongoing or repeating) psychosis include schizophrenia or schizoaffective disorder, bipolar disorder, and brain damage (usually as a result of alcoholism).[6][7] Acute (temporary) psychosis can also be caused by severe distress, sleep deprivation, sensory deprivation,[8] some medications, and drug use (including alcohol, cannabis, hallucinogens, and stimulants).[9] Acute psychosis is termed primary if it results from a psychiatric condition and secondary if it is caused by another medical condition or drugs.[9] The diagnosis of a mental-health condition requires excluding other potential causes.[10] Tests can be done to check whether psychosis is caused by central nervous system diseases, toxins, or other health problems.[11]

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.[12] Outcomes depend on the underlying cause.[2]

Psychosis is not well-understood at the neurological level, but dopamine (along with other neurotransmitters) is known to play an important role.[13][14][15] In the United States about 3% of people develop psychosis at some point in their lives.[1] Psychosis has been described as early as the 4th century BC by Hippocrates and possibly as early as 1500 BC in the 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 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. ^ Blackburn, Ronald (2005). "Psychopathy as a Personality Construct". American Psychiatric Association. Archived from the original on 5 September 2023. Retrieved 12 June 2024.
  5. ^ Driessen, Josi M. A.; van Baar, Jeroen M.; Sanfey, Alan G.; Glennon, Jeffrey C.; Brazil, Inti A. (July 2021). "Moral strategies and psychopathic traits". Journal of Abnormal Psychology. 130 (5): 550–561. doi:10.1037/abn0000675. hdl:2066/236779. ISSN 1939-1846. PMID 34472890.
  6. ^ 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.
  7. ^ "Korsakoff Psychosis – Special Subjects". MSD Manual Professional Edition. Retrieved 2024-04-10.
  8. ^ Gelder, Michael G.; Gath, Dennis; Mayou, Richard (1983). Oxford Textbook of Psychiatry. Oxford University Press. ISBN 978-0-19-261294-6.
  9. ^ 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.
  10. ^ 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.
  11. ^ 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.
  12. ^ 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.
  13. ^ 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.
  14. ^ 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.
  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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