Last reviewed:
Feb 15th 2023
LSW
Psychotic episodes can occur in the context of various mental, physical, and neurological conditions, and typically present with early warning signs. Noticing indicators of a psychotic episode can allow for early intervention and treatment, usually in the form of therapy or medication.
Psychotic episodes are characterized by a change in cognition, behavior, and thoughts, linked to an inability to make a distinction between reality and fantasy [1].
A psychotic episode may occur in the context of a mental health condition, including psychotic disorders such as schizophrenia and schizoaffective disorder, mood disorders such as bipolar disorder, or personality disorders such as borderline personality disorder [2].
They may also occur due to a neurological disorder such as Lewy body dementia, substance use disorder, or a medical condition such as infection or fever. Sleep deprivation, stress, and childbirth can also sometimes cause a psychotic episode to occur [1][3].
First-episode psychosis typically first occurs in adolescence or early adulthood. Research suggests that around 1% of the population experience a psychotic disorder, with around 3% experiencing at least one psychotic episode in their life [4][5].
Psychosis typically presents as one or more of the following five symptoms [6]:
Early warning signs may occur during the prodromal phase of psychosis, which will present as changes in thoughts, behavior, and emotions, but will not clearly be psychotic symptoms [4]. If untreated, the prodromal phase will become the active phase, in which psychotic symptoms will become clearer and more pervasive.
Early indicators of a psychotic episode may include [4][7][8]:
By spotting the early warning signs of a psychotic episode, it is possible to receive early intervention from a professional, who can make an appropriate diagnosis and recommend or provide treatment to reduce symptoms of psychosis. Untreated psychosis can lead to the condition becoming worse, potentially bringing harm to the sufferer and others.
Receiving treatment early can [4][5]:
An episode of psychosis can be managed effectively with therapy, medications, and self-care.
Cognitive behavioral therapy (CBT), interpersonal therapy, and family therapy can help by providing a better understanding and acceptance of psychosis, its symptoms, and the context in which it is occurring; understanding and managing underlying emotional causes; providing problem-solving and coping strategies; and increasing and improving support systems [1][7].
A doctor may prescribe medication to help manage and prevent further psychotic episodes. Typically, antipsychotic medications are used for psychosis, but medication may vary depending on the context in which a psychotic episode occurs [2]. For example, in the context of bipolar disorder, mood stabilizers may be prescribed.
Looking after your physical and mental health can help to prevent a psychotic episode from occurring. This may include [4][5]:
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