psychosis
Table of Contents
psychosis
see also:
introduction
features that suggest an organic cause (ie. not a primary psychiatric cause)
- clouding of consciousness
- focal neurologic abnormality
- inflammatory process - eg. febrile illness
- systemic disease
- atypical age of onset (> 35 years of age)
- lack of prior episodes of psychosis
- lack of expected family history
- focal symptoms (eg. unilateral hallucinations)
- non-auditory hallucinations
- catatonia
- co-existing deficit syndromes - delirium, dementia, aphasia, amnesia, etc
- atypical clinical course
- atypical response to treatment
aetiology
primary psychiatric
secondary to drugs
- see table below
secondary to medical conditions
- psychotic symptoms are common in the elderly due to underlying medical conditions and/or susceptibility to certain effects of medications
- most of these causes generally cause delirium as well but can sometimes present as an acute psychosis
neurologic conditions
- brain tumour, infection, cerebrovascular events
- intracranial infection - meningitis, etc
- intracranial haemorrhage
- SLE
- non-convulsive seizures
metabolic conditions
- hyponatraemia, hypernatraemia, etc
- sepsis
- etc
drugs which can cause psychotic symptoms (not just delirium)
adverse effects of normal doses of prescribed medications
- anti-muscarinic anticholinergic agents - particularly in the young and the elderly
- H2 antihistamines
- dopamine agonists
- 1st generation H1 antihistamines such as cimetidine (rare with 2nd generation)
uncommonly
- cephalosporins - esp. in renal impairment
- procaine derivatives
hypomania or mania
- tricylics - especially if bipolar disorder
adverse effects of toxic doses of prescribed medications
withdrawal reactions
recreational drugs
- psychedelic drugs
- LSD
- phencyclidine
- etc.
psychosis.txt · Last modified: 2011/10/04 21:09 (external edit)
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