Psychosis and Delirium

Psychosis

• Approximately 3% of people in the United States experience psychosis at some point in their lives.
• Around 100,000 adolescents and young adults in the US experience their first episode of psychosis each year.
• Psychosis is a condition where there is a loss of contact with reality, and the individual has difficulty understanding what is real and what is not real.
• Symptoms of psychosis include:
  • Delusions and hallucinations (seeing, hearing, or experiencing things that aren't real)
  • Incoherent or nonsensical speech
  • Inappropriate behavior for the situation
  • Depression, anxiety, sleep problems, social withdrawal, lack of motivation, and overall difficulty functioning
• Psychosis can be a symptom of various mental illnesses, such as schizophrenia, bipolar disorder, severe depression, or severe anxiety.
• Other potential causes of psychosis include:
  • Sleep deprivation
  • Medical conditions (e.g., hyperglycemia and hyperthyroidism)
  • Side effects of some prescription medications
  • Use of alcohol or other drugs

Early Signs of Psychosis

• Behavioral warning signs for psychosis include:
  • Drop in grades or worsening job performance
  • New trouble thinking clearly or concentrating
  • Suspiciousness or paranoia
  • Withdrawing socially
  • Unusual, bizarre new ideas
  • Strange feelings or having no feelings at all
  • Decline in self-care or personal hygiene
  • Difficulty telling reality from fantasy
  • Confused speech or trouble communicating

Symptoms of a Psychotic Episode

• According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), symptoms of a psychotic episode include:
  • Delusions
  • Hallucinations
  • Disorganized speech
  • Grossly disorganized or catatonic behavior
• A brief psychotic episode is defined as a psychotic event lasting at least one day but less than one month, with an eventual return to previous level of functioning.

Treatment of Psychosis

• Treatment for psychosis is based on its cause.
• If psychosis is caused by a medical condition, side effects of medication, or withdrawal from a substance, it will resolve as these conditions are treated.
• If psychosis is a symptom of mental illness, treatment typically includes a combination of antipsychotic medicines and psychological therapies.

Delirium

• Delirium is a mental state in which the client becomes temporarily confused, disoriented, and not able to think or remember clearly.
• Delirium is often referred to as psychosis caused by medical issues.
• Delirium resolves as the underlying condition is effectively treated.
• Common causes of delirium include:
  • Dehydration and electrolyte imbalances
  • Dementia
  • Hospitalization, especially in intensive care
  • Intoxication or withdrawal from alcohol or drugs
  • Kidney or liver failure
  • Medications
  • Metabolic disorders, such as diabetic ketoacidosis (DKA)
  • Serious infections
  • Severe pain
  • Sleep deprivation
• Symptoms of delirium include:
  • Changes in alertness
  • Changing levels of consciousness
  • Confusion
  • Disorganized thinking or talking
  • Disrupted sleep patterns or sleepiness
  • Emotional changes
  • Hallucinations and delusions
  • Incontinence
  • Memory problems
  • Trouble concentrating
• Interventions for managing delirium include:
  • Ensuring a quiet and well-lit room
  • Providing clocks and calendars
  • Encouraging family presence
  • Ensuring hearing aids and glasses are worn
  • Allowing for undisrupted sleep
  • Encouraging patient mobility
  • Controlling pain
  • Administering prescribed medications
  • Avoiding restraints

This quiz covers the concepts of psychosis and delirium in mental health. It includes the prevalence of psychosis in the United States and its effects on adolescents and young adults.