psychose

Psychose, or psychosis, is a broad term in psychiatry for mental health conditions in which a person loses touch with reality. It is marked by symptoms such as delusions, hallucinations, disorganized thinking or speech, and impaired insight or judgment. Psychosis can occur as a primary mental disorder or as a result of another medical condition, substance use, or a mood disorder.

Types and causes: Primary psychotic disorders include schizophrenia spectrum disorders, schizotypal or delusional disorder, and schizoaffective disorder. Secondary psychosis may be caused by medical illnesses (for example brain injury, infection, metabolic disturbances), substances (illicit drugs, alcohol withdrawal, some medications), or mood disorders with psychotic features. Risk factors include genetic vulnerability, early brain development factors, stress, and substance use.

Symptoms: Positive symptoms include delusions and hallucinations; disorganized speech and behavior. Negative symptoms include diminished emotional expression, avolition, and reduced speech. Cognitive difficulties may also be present.

Diagnosis: Diagnosis relies on clinical assessment and standardized criteria (for example DSM-5-TR or ICD-11). The presentation typically involves delusions or hallucinations plus disturbances in thinking, language, or behavior, with sufficient duration and impairment. Delirium, mood disorders with psychotic features, and substance-induced psychosis are considered in the differential diagnosis.

Treatment and prognosis: Treatment usually combines antipsychotic medications (typical or atypical) with psychosocial interventions, such as family education, supported employment, and cognitive-behavioral therapy. Early intervention improves outcomes; many patients require long-term treatment and have a risk of relapse. Outcome varies widely, influenced by duration of untreated psychosis, comorbidity, and social support.

Epidemiology: About 0.5–1% of people experience a psychotic disorder in their lifetime; onset is typically in late adolescence or early adulthood, with men often presenting earlier than women.