04/12/2013 by admin | Psychiatry

Definition: “a loss of contact with reality”.

Classification / type of disease:


Presenting symptoms / signs:

  • Visual / auditoryhallucinations
  • Delusional beliefs (some paranoid in nature)
  • Personality changes
  • Thought disorder (loosening of associations, that is, a disconnection and disorganization of the semantic content of speech and writing)

Diagnostic investigations:

The Brief Psychiatric Rating Scale (BPRS) assesses the level of 18 symptom constructs of psychosis such:

  • Hostility
  • Suspicion (mistrust and doubt about another person’s honesty)
  • Hallucination
  • Grandiosity (unrealistic sense of superiority – a sustained view that you are better than everyone else).

During the initial assessment and the follow-up, both positive and negative symptoms of psychosis can be assessed using the 30 item Positive and Negative Symptom Scale (PANSS)


Various psychiatric causes including =

  • Psychosocial stress
  • Sleep deprivation
  • Epilepsy

General medical =

  • Dementia
  • Sarcoid
  • MS
  • Alzhemiers
  • Parkinsons
  • Electrolyte disorders

Pathophysiology: complex


  • Treat the cause
  • May require antipsychotics
  • Hospitalization
  • If no medicines help – electroconvulsive therapy (ECT) may help
  • Early intervention – if recognise prodrome – CBT may help avoid progression to psychosis.
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