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Psychosis

Definition

Psychosis is a general term that refers to any significant mental disorder with hallucinations or delusions that has a physical or emotional source. It is a severe disturbance in which a person is unable to distinguish reality from fantasy.

What is going on in the body?

Psychosis is considered a mental and behavioral disorder. It results in a significant distortion of a person's thought processes. The person has problems recognizing reality and relating to other people. These distortions are serious enough to interfere with the person's ability to deal with the normal demands of everyday life.

Risks

What are the causes and risks of the condition?

Psychotic illnesses can have a physical or emotional cause.
Some psychotic disorders include:
  • Wernicke-Korsakoff's syndrome, a neurologic disorder that causes a wide variety of symptoms
  • drug- or alcohol-induced psychosis
  • delirium from a host of medical causes or side-effects of medicines
  • bipolar disorder
  • severe affective, or mood, disorders
  • schizophrenia

Prevention

What can be done to prevent the condition?

In general, there is no known way to prevent psychosis. Psychoses that are the result of drugs or alcohol use can be prevented by avoiding these substances.
If a person has a mood disorder, it can be treated early to prevent psychosis from developing.

Diagnosed

How is the condition diagnosed?

Psychosis is diagnosed based on the person's symptoms and how long the person has had them. Psychological evaluation and testing can help to pinpoint the exact type of psychosis. A cranial CT scan or cranial MRI may be done to help rule out other causes for the symptoms.

Long Term Effects

What are the long-term effects of the condition?

The psychosis may prevent the person from functioning normally in society.

Other Risks

What are the risks to others?

Psychosis is not contagious, but a person with psychosis may cause harm to others when he or she loses contact with reality.

Treatments

What are the treatments for the condition?

Treatment varies depending on the cause of the psychosis. Medication and hospitalization are all helpful in treating psychosis. During sudden flare-ups, the psychotic symptoms may be severe enough that the person needs to be protected.
If suicide or homicide is part of the person's delusions, the person will need to be hospitalized urgently.
Antipsychotic medications include:
  • olanzapine (i.e., Zyprexa)
  • risperidone (i.e., Risperdal)
  • quetiapine (i.e., Seroquel)
  • ziprasidone (i.e., Geodon)
  • haloperidol (i.e., Haldol)
  • thiothixene (i.e., Navane)
  • thioridazine (i.e., Mellaril)
  • trifluoperazine (i.e., Stelazine)
  • chlorpromazine (i.e., Throazine) may be helpful

Side Effects

What are the side effects of the treatments?

Potential side effects from antipsychotic medication can include:
  • muscle rigidity
  • prolonged muscle contractions
  • extreme slowness of movement
  • abnormal movements (movement disorder)
  • stiffness
  • shaking
  • excessive sedation
  • restlessness
  • weight gain, diabetes, increased risk of cardiovascular disease
  • loss of sexual interest
These medication side effects are common. They will usually go away once the person stops taking the medication, except in the case of movement disorders resulting from long-term use of antipsychotic medications.

After Treatment

What happens after treatment for the condition?

Psychosis can be controlled with treatment in some cases. The success of the treatment varies depending on the cause.

Monitor

How is the condition monitored?

Careful monitoring of the person is necessary. Medications need to be monitored to make sure that the correct dose is given. A healthcare professional (preferably a psychiatrist) should be consulted if the person loses contact with reality, or has any new or worsening symptoms.

Sources

Tierney, Lawrence, editor, "Current Medical Diagnosis and Treatment, 39th edition", 2000

Stuart and Sundeen, Principles and Practice of Psychiatric Nursing: 4th edition, 1991

The Merck Manual of Medical Information, 1997

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