Acute psychosis


  • Caused by many psychiatric as well as medical conditions

Clinical Features

  • Agitation, restlessness, irritability
  • Decreased attention
  • Inappropriate or hostile behaviors
  • Hallucinations, delusions, paranoia
  • +/- additional features of underlying pathology (e.g. signs of intoxication/withdrawal, trauma)

Differential Diagnosis

Altered mental status

Diffuse brain dysfunction

Primary CNS disease or trauma


Psychiatric Disorders with Psychotic Symptoms


  • Rule out any organic causes or contributing factors

General ED Psychiatric Workup


  • Treat underlying condition!

General ED Psychiatric Management


  • Depends on underlying cause of psychosis
  • Hospitalization for first psychotic episode, suicidal or homicidal, unable to care for self or poor support system

See Also


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