What Are the Early Warning Signs of Psychosis?

Hallucinations are a symptom of psychosis.

Psychosis is a symptom of psychiatric disorders that affects the way the brain perceives reality. Patients who have psychosis may be unable to distinguish reality from psychotic hallucinations (seeing or hearing things that are not there) or delusions (false beliefs).

Psychiatric disorders that may include psychosis as a symptom include:

• Schizophrenia
• Bipolar disorder
• Severe depression, including postnatal depression
• Drug-induced psychosis, which is a result of using or withdrawing from alcohol, marijuana, amphetamines, LSD, ecstasy, or mushrooms
• Brief reactive psychosis (rare) caused by a stressful event (symptoms are usually short-lived)
• Certain illnesses such as Alzheimer's disease
• Certain medications may induce psychosis.

Before psychosis appears, there are often changes in behavior that occur that may be early warning signs, such as:

• new onset of difficulty thinking clearly or concentrating;
• suspicion, paranoia, or unease with other people;
• social withdrawal;
• abnormal and overly intense new ideas, strange feelings, or lack of feelings;
• decline in grades or job performance;
• deterioration in self-care or personal hygiene;
• difficulty distinguishing fantasy from reality; and
• disordered speech or trouble communicating.

Symptoms and signs of psychosis include the following:

• Hallucinations (seeing or hearing things that are not there)
• Delusions (false beliefs)
• Incoherent or nonsense speech
• Inappropriate behaviors for the situation
• Depression
• Anxiety
• Sleep problems
• Social withdrawal
• Lack of motivation
• Overall difficulty functioning

There are a number of possible causes of psychosis, such as:

• a symptom of a mental illness, such as schizophrenia or bipolar disorder;
• sleep deprivation;
• certain medical conditions, such as Alzheimer's disease;
• certain prescription medications; and
• alcohol or drug abuse.

Psychosis is typically diagnosed after an evaluation by a psychiatrist, psychologist, social worker, or another type of mental health counselor. This involves the medical professional asking questions about symptoms and signs.

In some cases, medical professionals may order the following tests to determine if there is an underlying medical cause for the psychotic symptoms and signs:

• Urine test for drugs of abuse
• Liver function tests may reveal alcohol abuse
• Complete blood count (CBC) to check for systemic infection or chronic disease
• Blood tests for syphilis or HIV
• Computerized tomography (CT) scan or magnetic resonance imaging (MRI) of the brain to check for tumors or brain lesions
• Thyroid tests to rule our thyroid disorders
• Electrolyte and calcium levels to rule out metabolic disturbance
• Electroencephalography (EEG) to check for epilepsy

Treatment for symptoms of psychosis usually includes a combination of medications and psychological therapies.

Medications used to treat psychosis include

• antipsychotics,
• antidepressants, and
• anti-anxiety drugs.

Therapies used to treat psychosis include

• cognitive behavioral therapy (CBT),
• cognitive enhancement therapy (CET),
• family interventions and education, and
• support groups.

Complications of untreated psychosis include the following:

• Disruptions in school and work
• Strained family relationships
• Separation from friends
• Substance abuse
• Frequent visits to a hospital's emergency department or admittance to a hospital
• Legal problems
• Homelessness

Certain conditions that cause psychosis can result in a shortened lifespan. Patients with schizophrenia live on average 14½ fewer years than people who do not have the disorder.

Life expectancy for patients with Alzheimer's disease ranges from 3 to 10 years following diagnosis.