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Psychosis

A severe mental disorder in which a person loses the ability to recognize reality or relate to others. Symptoms include being paranoid, having false ideas about what is taking place or who one is, and seeing, hearing, or feeling things that are not there.

PubMed Health Glossary
(Source: NIH - National Cancer Institute)

Examples of Conditions That May Involve Psychosis

What works? Research summarized

Evidence reviews

Effectiveness of psychoeducation for relapse, symptoms, knowledge, adherence and functioning in psychotic disorders: a meta-analysis

Psychoeducation (PE) for schizophrenia and other psychotic disorders is widely adopted but insufficiently evaluated. So far, meta-analytic data has demonstrated efficacy for PE when interventions include family members. Whether PE directed solely at patients is also effective remains unclear. The current meta-analysis evaluates short- and long-term efficacy of PE with and without inclusion of families with regard to relapse, symptom-reduction, knowledge, medication adherence, and functioning. Randomized controlled trials comparing PE to standard care or non-specific interventions were included. A literature search in the Cochrane Library, PsycINFO and Medline retrieved 199 studies for closer examination, of which 18 studies, reporting on 19 comparisons, met the inclusion criteria. These studies were coded with regard to methodology, participants, interventions and validity. Effect sizes were integrated using the fixed effects model for homogeneous effects and the random effects model for heterogeneous effects. Independent of treatment modality, PE produced a medium effect at post-treatment for relapse and a small effect size for knowledge. PE had no effect on symptoms, functioning and medication adherence. Effect sizes for relapse and rehospitalization remained significant for 12 months after treatment but failed significance for longer follow-up periods. Interventions that included families were more effective in reducing symptoms by the end of treatment and preventing relapse at 7-12 month follow-up. Effects achieved for PE directed at patients alone were not significant. It is concluded that the additional effort of integrating families in PE is worthwhile, while patient-focused interventions alone need further improvement and research.

Antipsychotic-induced weight gain in chronic and first-episode psychotic disorders: a systematic critical reappraisal

The authors concluded that antipsychotic-induced weight gain was 3-fold to 4-fold greater in young patients with first-episode psychosis, in both long-term and short-term medications, compared to patients with chronic psychotic disorders. The review process was limited by methodological flaws in the areas of study selection and quality assessment; therefore the authors' conclusions may not be reliable.

Vocational rehabilitation in schizophrenia and other psychotic disorders: a literature review and meta-analysis of randomized controlled trials

This review investigated the effects of vocational rehabilitation for individuals with severe mental illness. The authors concluded that supported employment programmes have produced consistently better rates of employment than traditional vocational rehabilitation. A lack of information on the review methodology and quality of the included studies makes it difficult to assess the reliability of the evidence underlying the authors' conclusions.

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Summaries for consumers

Chlorpromazine for treating aggression or agitation due to psychosis

Chlorpromazine was the first medicine specifically developed to treat psychoses as it helps people to feel less anxious, tense or angry. This review systematically examines the evidence to see how effective chlorpromazine is at reducing aggression or agitation due to psychosis. From the evidence available, we are unable to draw any firm conclusion about using this medicine for this purpose. We found that chlorpromazine was just as effective at reducing aggression or agitation due to psychosis as similar medicines, but that it may be associated with more side effects than other medicines. Further research is needed to clarify whether chlorpromazine is effective at reducing psychosis induced aggression or agitation. Such research would be best carried out using carefully designed clinical trials.

Antipsychotic drugs for non‐affective psychosis during pregnancy and postpartum

Women who suffer with psychotic conditions who become pregnant are usually treated with antipsychotic drugs. The risks of harm to the offspring associated with exposure to these drugs, in utero or through breast‐feeding, are unknown. We aimed to find good quality evidence from randomised controlled trials on the risks and benefits of antipsychotic drugs during pregnancy and breastfeeding for both the woman and the foetus/infant. We found none. Ethical constraints concerning randomisation of treatment for pregnant and breastfeeding women, the logistics of such a study and a lack of impetus from the pharmaceutical industry in this area may explain the lack of research. However, the continued use of antipsychotic drugs in these women during pregnancy and lactation without sound evidence raises serious clinical and ethical concerns.

Interventions for psychotic symptoms concomitant with epilepsy

Little evidence to inform the treatment of psychosis in people with epilepsy.

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More about Psychosis

Photo of an adult woman

See Also: Bipolar Disorder, Schizophrenia

Other terms to know:
Hallucinations, Paranoia

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