Psychosis: Introduction
Description Psychosis is characterised by a loss of contact with reality, and may present with: Delusions: Fixed, unshakeable, false beliefs which are not in keeping with a person’s society, culture, or religion. Beliefs may be persecutory, referential, grandiose, religiose, erotic, or bizarre in nature. Hallucinations: Perceptual disturbances, e.g. auditory hallucinations, which are heard as voi
Description
Psychosis is characterised by a loss of contact with reality, and may present with:
- Delusions: Fixed, unshakeable, false beliefs which are not in keeping with a person’s society, culture, or religion. Beliefs may be persecutory, referential, grandiose, religiose, erotic, or bizarre in nature.
- Hallucinations: Perceptual disturbances, e.g. auditory hallucinations, which are heard as voices distinct from the patient’s thoughts.
- Disorganised thinking: Manifests as disordered flow of speech, such that the person does not make sense.
- Grossly disorganised or abnormal motor behaviour (including catatonia).
- Negative symptoms: reduced emotional expression, apathy, avolition, lack of speech, lack of social interaction.
Psychosis occurs in psychotic disorders (which may be acute, transient, or chronic), other psychiatric conditions such as bipolar disorder or depression, medical conditions (e.g. certain types of epilepsy), or substance use (intoxication or withdrawal).
Psychosis is often accompanied by a lack of insight into the symptoms and poor judgement. The risk to self and others must always be assessed. It may be necessary to treat as an Assisted or Involuntary User under the MHCA.
Standard Treatment Guidelines and Essential Medicines List for South Africa Primary Healthcare Level_Chapter 16: Mental Health Conditions_NEMLC Recommendations for Medicine Amendments 2020_2023