What is Acute Psychosis?

Acute psychosis is a condition that is usually differentiated from chronic psychosis. Chronic psychosis tends to refer to a long-lasting condition, where people may sometimes act normally, but at other times may suffer from periods of rage, hallucination, delusions and the like. People who have schizophrenia may have periods such as this, despite medication, and their condition is therefore chronic.

That doesn’t mean that a person who has a chronic psychotic condition never suffered from acute psychosis. Onset of their disease may have resulted in sudden symptoms of psychosis that are hard to mistake, and those phases when a person is not significantly in touch with reality may be thought of as acute phases. Yet, acute psychosis does not always indicate a mental illness. Some people suffer it as a result of illness, infection, high fevers, use of illegal and/or legal medications and drugs, or for other reasons. Trying to identify cause of acute psychosis is part of the work of physicians so that treatment is appropriate.

Treatment can be difficult because a person with acute psychosis may be violent, may be a danger to self or others, and usually is not aware enough to fully consent to treatment. In most cases, family members who usually notice symptoms right away bring those who suddenly develop psychotic symptoms into hospitals. Emphasis in treatment is protecting patients, protecting staff, and trying to resolve overt symptoms so that a diagnosis and course of treatment can be determined.

In a hospital setting, a person with acute psychosis may need to be treated without their consent. This may mean administering medications that tranquilize the patient and placing the patient in restraints if necessary. If the psychosis has resulted in self-harming actions like attempts at suicide, treatment is given as needed to combat things like overdose or injury. Yet it can be very difficult to treat a person if they are in a combative or resistant state, so the first goal is usually to use medications that will promote calmer behavior.

An acute psychotic state can be very short lived, lasting only a few hours, or it may be longer lasting and persist for several weeks. Much depends upon cause, ability to diagnose, chance of the causal condition going into remission, and availability of effective treatment. Even a person with severe onset of things like hallucinations may have moments of lucidity and be able to participate in treatment decisions.

When the cause is clearly due to mental illness, patients may spend some time in a mental health facility, where staff is most trained to help patients with acute psychosis, and to make decisions about how to best treat those patients. Usually a person who becomes psychotic for other reasons, such as a one-time use of drugs or due to a severe infection, is treated in a standard hospital, where once treatment is undertaken, it is unlikely that acute psychosis will recur.