Psychosis

Psychosis
Other namesPsychotic break (colloquial)
SpecialtyPsychiatry, emergency medicine, clinical psychology
SymptomsDelusions, hallucinations, incoherent speech and behavior
ComplicationsSelf-harm, suicide
CausesMental illness (schizophrenia, bipolar disorder), trauma, sleep deprivation, some medical conditions, certain medications, drugs (including alcohol, caffeine and cannabis)
TreatmentAntipsychotics, counselling, social support
PrognosisDepends on cause
Frequency3% of people at some point in their life (US)

In psychopathology, psychosis is a condition in which a person is unable to distinguish, in their experience of life, between what is and is not real. Examples of psychotic symptoms are delusions, hallucinations, and disorganized or incoherent thoughts or speech. 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 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). Acute (temporary) psychosis can also be caused by severe distress, sleep deprivation, sensory deprivation, some medications, and drug use (including alcohol, cannabis, hallucinogens, and stimulants). Acute psychosis is termed primary if it results from a psychiatric condition and secondary if it is caused by another medical condition or drugs. The diagnosis of a mental-health condition requires excluding other potential causes. Tests can be done to check whether psychosis is caused by central nervous system diseases, toxins, or other health problems.

Treatment may include antipsychotic medication, psychotherapy, and social support. Early treatment appears to improve outcomes. Medications appear to have a moderate effect. Outcomes depend on the underlying cause.

Psychosis is not well-understood at the neurological level, but dopamine (along with other neurotransmitters) is known to play an important role. In the United States about 3% of people develop psychosis at some point in their lives. Psychosis has been described as early as the 4th century BC by Hippocrates and possibly as early as 1500 BC in the Ebers Papyrus.