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Psychosis, Acute, Emergency Medicine

Reviewed 06/2017
 


Basics

Description

  • Disorder of brain function characterized by loss of contact with reality, abnormal perceptions, disorganization of emotions, thought, and behavior

  • Dopamine pathways are strongly impli...

Diagnosis

Signs and Symptoms

  • Delusions are fixed, false beliefs that are:

    • Impervious to outside logic

    • Often persecutory, religious, or somatic content

  • Hallucinations:

    • Sensory experiences in the absence of ...

Treatment

Pre-Hospital

  • Patients can display unpredictable and violent behavior toward themselves and others

  • Patients may require police presence or restraints to maintain safety

  • Local laws vary regarding...

Follow-Up

Disposition

Admission Criteria

  • If nonpsychiatric etiology, admit to appropriate medical service

  • If psychiatric etiology and patient is medically stable, patient may require admission to a psych...

Pearls and Pitfalls

  • Psychotic symptoms should be evaluated for treatable medical causes and not assumed to be solely psychiatric in nature even in patients with known mental illness

  • Visual, olfactory, ...

Additional Reading

  • Byrne  P. Managing the acute psychotic episode. BMJ.  2007;334(7595):686–692.

  • Mathias  M, Lubman  DI, Hides  L. Substance-induced psychosis: A diagnostic conundrum. J Clin Psych...

Codes

ICD9

  • 292.9 Unspecified drug-induced mental disorder

  • 298.8 Other and unspecified reactive psychosis

  • 298.9 Unspecified psychosis

  • 294.9 Unspecified persistent mental disorders due to conditions classif...

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