Psychotic Disorders
Psychotic disorders affect how a person interprets reality, but psychosis is a symptom pattern rather than a single diagnosis. New psychosis requires assessment for psychiatric, substance-related, neurological and other medical causes.
Key takeaways
- Hallucinations, fixed false beliefs, severely disorganised speech or marked behavioural change can indicate psychosis.
- Onset, mood symptoms, substances, medicines, physical illness and immediate safety determine the assessment and level of care.
- Antipsychotics may reduce symptoms, but choice and follow-up must account for movement, metabolic, cardiac and other adverse effects.
Catalogue matches are not a psychiatric diagnosis and do not show that an antipsychotic is appropriate.
What can psychosis look like?
A person may hear voices, feel watched or threatened, struggle to organise thoughts, withdraw or have difficulty meeting basic needs. Similar presentations can occur in mood disorders, delirium, dementia, epilepsy or after substance use.
How do medicines fit into care?
Treatment combines attention to the cause, safety, practical support and psychological or social care. Chlorpromazine is one older antipsychotic; it is not suitable for every presentation and requires adverse-effect monitoring.
When to seek urgent care
Get urgent help for immediate danger, suicidal or violent intent, severe agitation, inability to eat or drink, rapidly worsening confusion, or new psychosis with fever, seizure, head injury or reduced consciousness.