Psychosis

About Psychosis

Psychosis is a symptom, not a diagnosis, describing a loss of contact with reality. It can occur in schizophrenia and related disorders, bipolar disorder, severe depression, substance intoxication or withdrawal, and many medical and neurological conditions, and a minority of people experience a psychotic episode at some point in their lives. Its main features are hallucinations, which are perceptions without an external source and most often auditory; delusions, which are fixed false beliefs, often persecutory, grandiose or referential; disorganized thinking and speech; and disorganized or abnormal motor behavior. A first episode is often preceded by a prodromal period of months or longer with subtle changes such as declining functioning, social withdrawal, suspiciousness, unusual thoughts, sleep problems and mood changes. The duration of untreated psychosis, meaning the time between onset and treatment, is an important prognostic factor, with shorter delays associated with better outcomes. Coordinated specialty care programs for first episode psychosis bring together antipsychotic medication, family psychoeducation, supported employment and education, cognitive behavioral therapy for psychosis and case management, and they have been shown to improve recovery. Many people recover well after a first episode, while others experience recurring episodes and benefit from longer term support.