Psychosis( updated Oct 2006)

Psychosis is a general term which refers to a significant mental disorder which results in a severe disturbance in which a person is unable to distinguish reality from fantasy. The cause of this can be either a physical or emotional disturbance.

Psychosis results in a significant distortion of a person's mental capacity. The person has problems recognising 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.

The signs and symptoms of psychosis include:

• loss of touch with reality
• delusions, or false beliefs
• illusions, or mistaken beliefs
• seeing, hearing, or perceiving things that are not there
• disorganised speech
• excitement
• confusion
• depression
• agitated and inattentive behaviour

Psychotic illnesses can have a physical or emotional cause. The causes include such disorders as:

• Wernicke-Korsakoff's syndrome, a personality disorder that causes a wide variety of symptoms
• senile dementia or Alzheimer's disease, which involve memory loss and other changes
• drug- or alcohol-induced psychosis
• manic depression
• severe affective, or mood, disorders, schizpophrenia

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.

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.

Treatment varies depending on the cause of the psychosis. Psychotherapy, medication, and hospitalisation are all helpful in treating psychosis.

During relapses of 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 may need to be hospitalised. Antipsychotic medication such as haloperidol, chlorpromazine and a vast array of newer agents may be helpful. In treatment resistant cases, a drug called Clozapine may be useful. All these drugs have side effects in short term and long term used and a psychiatrist should be consulted to discuss options for treatment at least initially. Side effects are common and if not addressed can often lead to person stops taking the medication, which subsequently lead to relapses in the psychotic symptoms. Treatment of psychosis requires regular review as the symptoms are not always stable and can be very sensitive to changes in the persons life. Careful monitoring of the person is necessary.

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