Alternative names 

Psychosis is a loss of contact with reality, typically including delusions (false ideas about what is taking place or who one is) and hallucinations (seeing or hearing things which aren’t there).

Causes, incidence, and risk factors

Psychosis is a severe mental condition characterized by a loss of contact with reality. There are numerous potential causes:


  • loss of touch with reality  
  • seeing, hearing, feeling, or otherwise perceiving things that are not there (hallucinations)  
  • disorganized thought and/or speech  
  • emotion is exhibited in an abnormal manner  
  • extreme excitement (mania)  
  • confusion  
  • Depression and sometimes suicidal thoughts  
  • unfounded fear/suspicion  
  • mistaken perceptions (illusions)  
  • false beliefs (delusions)

Signs and tests
Psychological evaluation and testing are used to diagnosis the cause of the psychosis.

Laboratory or radiological testing may not be essential, but sometimes can help pinpoint the exact diagnosis. This may include:

  • MRI of the brain  
  • tests for Syphilis  
  • drug screens


Treatment varies depending on the cause of the psychosis. Care in a hospital is often needed to ensure safety of the patient. Drugs that diminish auditory hallucinations and delusions and stabilize thinking and behavior (antipsychotic drugs) are helpful. Group or individual therapy can also be useful.

Expectations (prognosis)

The expectations for the outcome vary with the specific disorder. Many of the symptoms can be controlled with long-term treatment.

Psychosis can prevent a person from functioning normally. During psychotic states, there can be an inability to care for oneself. If the condition is left untreated, there is a possibility of self-harm or harm to others.

Calling your health care provider
Call your health care provider or mental health professional if a member of your family exhibits behavior indicating a lloss of contact with reality. If there is any concern about safety, as described above, immediately take the person to the nearest emergency room for evaluation.

Prevention depends on the cause. For example, preventing Alcohol Abuse avoids alcohol induced psychosis.

Johns Hopkins patient information

Last revised: December 3, 2012
by Martin A. Harms, M.D.

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