What Is ICU Psychosis?

Reviewed by Whitney White, MS CMHC, NCC., LPC

Published 12/23/2020

ICU Psychosis is not often discussed, but unfortunately, it is rather common in those who are intensive care units or similar facilities for five days or more. But, you might wonder, what is ICU psychosis? If you came across this article not knowing much about what psychosis is or why this temporary form of psychosis occurs, this blog post should answer your questions. In this blog post, we will cover ICU psychosis in-depth and its treatment, symptoms, prevention, and how it differs from long-term psychotic disorders like Schizophrenia.

What Is Psychosis?

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Psychosis, put simply, refers to a disconnect from reality. It often includes disorganized speech, hallucinations, delusions, paranoia, agitation, and more. The American Psychological Association or APA dictionary describes psychosis as: "an abnormal mental state involving significant problems with reality testing. It is characterized by serious impairments or disruptions in the most fundamental higher brain functions—perception, cognition, and cognitive processing, and emotions or effect—as manifested in behavioral phenomena, such as delusions, hallucinations, and significantly disorganized speech." Often, psychosis is caused by mental health conditions like Schizophrenia, but there are cases where psychosis can be temporary and where it can be caused by other things. ICU psychosis is one of those scenarios.

ICU Psychosis Definition

What is ICU psychosis? First, ICU stands for "intensive care unit." ICU psychosis, also called ICU delirium or hospital psychosis, is a temporary form of psychosis that occurs when someone is in an intensive care unit or another similar setting. In other words, ICU psychosis is a type of psychosis defined by the APA definition of psychosis that is listed above. Still, it occurs specifically in ICU units or similar medical units. Most of the time, people are in intensive care units because they are seriously ill with an infection, heart problems, or because they need specific and unique care. ICU psychosis can be caused by a number of things that may occur in an ICU unit or a similar place. Potential causes of ICU psychosis include but are not limited to stress, feelings that one has lost control over their life, lack of orientation, sleep disturbance or sleep deprivation, sensory deprivation, constant medical monitoring that is disruptive to the individual, infections, critical illness, side effects from medical treatments, or dehydration.

As you can see, many of these factors would be considered environmental. That is why many intensive care units are taking steps to minimize these risk factors. The good news about ICU psychosis or psychosis caused by any of the above is that it does go away.

ICU Psychosis Symptoms

Symptoms of ICU psychosis may include but aren't limited to:

  • Hallucinations (such as seeing or hearing things that aren't there)
  • Delusions (firmly held false beliefs)
  • Clouding of consciousness
  • Paranoia
  • Abnormal behavior
  • Agitation
  • Severe anxiety
  • Disorientation
  • Nightmares

ICU Psychosis Treatment

Things that may go into combatting ICU psychosis may include:

  • Treating the root of the psychosis, if applicable (for example, if a patient is dehydrated, treating dehydration, or if due to lack of sleep, making sure that the client can get sleep).

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  • Changing the environment could include creating a more comfortable environment through changes in the lighting, visits from family members, and so on.
  • Medication, if applicable (always refer to a medical or mental health professional for any and all advice regarding medication and other treatments)

How Long Does ICU Psychosis Last?

The length of ICU psychosis varies from person to person and can last from one day to two weeks. Often, it goes away after a client can get some sleep, and it should resolve entirely once a client leaves the ICU or a similar setting or soon after. ICU psychosis can be dangerous, but ICU psychosis is not permanent. Many intensive care units are taking steps to prevent ICU psychosis as much as possible. ICU psychosis stories will vary from person to person. If you are the loved one of someone who has gone through this or is going through this right now, it can be incredibly scary and worrying to witness, but again, it does go away.

Are There Other Forms Of Brief Or Temporary Psychosis?

Other forms of brief or temporary psychosis do not occur in ICU units. In fact, there are several diagnoses in the diagnostic and statistical manual of mental disorders or DSM that are used for brief episodes of psychosis. Here are some ways that brief or temporary psychosis can present outside of ICU units:

Brief Psychotic Disorder

Brief Psychotic Disorder is a diagnosis characterized by symptoms of psychotic disorders (such as hallucinations and delusions) that are only prevalent for one day to less than one month. When diagnosing this disorder occurs, it should be specified if this period occurs post-partum, during acute stress, or alongside other specifiers. The brief psychotic disorder is distinguished from schizophreniform disorder and other Schizophrenia spectrum disorders based on one's psychosis duration.

Schizophreniform Disorder

Schizophreniform Disorder is a diagnosis that's characterized by symptoms of Schizophrenia, which last for a shorter duration of time than they would in an individual with Schizophrenia or a Schizophrenia diagnosis. More specifically, the symptoms will be present for at least a month, but they will not meet the six-month or longer disturbance that's required for a diagnosis of Schizophrenia. Again, the difference between Schizophreniform Disorder and Brief Psychotic Disorder (see above) is that Brief Psychotic Disorder will last for less than a month, where Schizophreniform symptoms must last for at least a month.

Substance/Medication-Induced Psychotic Disorder

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Substance/Medication-Induced Psychotic Disorder is a diagnosis characterized by psychotic symptoms or symptoms of psychosis caused by substances. Once the substance is removed, the psychosis symptoms will likely dissipate.

Psychotic Disorder Due To Another Medical Condition

Psychotic Disorder Due To Another Medical Condition is a diagnosis characterized by psychotic symptoms caused by another medical complication or illness. For example, this diagnosis may come following a stroke, infection, or a brain tumor.

If symptoms of psychosis are ongoing or long-lasting outside of the specified spectrum of time listed in these diagnoses, the individual may have another, more stable condition. Just as you must rely on a medical or mental health professional for information about appropriate treatment for each individual, since every case is so unique, it is vital to see a medical or mental health provider for the correct diagnoses.

ICU Psychosis Vs. Schizophrenia

Schizophrenia is a chronic mental health condition. Unlike ICU psychosis, Schizophrenia does not go away. Symptoms of Schizophrenia may include but are not limited to:

  • Hallucinations (such as seeing or hearing things that aren't there)
  • Delusions (firmly held false beliefs)
  • Disorganized thoughts and disorganized speech
  • Abnormal posture or abnormal movements
  • Trouble concentrating or focusing
  • Trouble sleeping
  • Social isolation or withdrawal from others
  • Negative symptoms, such as a flat affect, poverty of speech, and apathy

Seeing the list above, you may be confused - aren't these similar to the symptoms of ICU psychosis? The answer is yes, but the difference is in the duration of time and other factors, such as if a person's symptoms go away or not, if there was an underlying cause or contributor to the psychosis (such as dehydration), and so on. Another chronic (ongoing/life-long) condition under the category of Schizophrenia spectrum and other psychotic disorders is schizoaffective disorder, which is characterized by Schizophrenia symptoms paired with mood disorder symptoms.

Again, ICU psychosis goes away, but Schizophrenia and schizoaffective disorder don't. The good news for those living with schizophrenia or schizoaffective disorder is that these are treatable mental health conditions. If you have a disorder categorized as a Schizophrenia spectrum disorder, you are not alone, and help is out there.

Help For Schizophrenia And Related Disorders

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If you notice symptoms of Schizophrenia, it is important to see a medical or mental health provider right away. Again, Schizophrenia is a treatable condition, and with symptom management, a person living with the disorder can live a full, happy life. Many people with Schizophrenia and related disorders who seek treatment benefit from therapy or counseling. Therapies such as cognitive enhancement therapy (CET) are a common treatment option which can also be combined with other treatment options, such as medications, in some cases. Always consult a medical or mental health professional for advice and guidance on medication and specific treatment options. Peer support can be beneficial for those living with Schizophrenia and other similar disorders in conjunction with treatment. Common peer support options include support groups and online support forums. There are peer support options both for those living with these disorders and loved ones of those living with Schizophrenia spectrum and other psychotic disorders. You can look for peer support options that meet in person, online, or over voice call by searching the web for "Schizophrenia support groups near me," "Schizophrenia support online," or other similar terms. The SARDAA (Schizophrenia And Related Disorders Alliance of America) website is an excellent resource for those seeking information and support about Schizophrenia and other related disorders.

Take The Mind Diagnostics Schizophrenia Test

After reading the Schizophrenia symptoms and criteria listed above, are you wondering if you could have Schizophrenia or symptoms of Schizophrenia? If so, consider taking the Mind Diagnostics Schizophrenia test on our website. While taking the Mind Diagnostics Schizophrenia test cannot replace a diagnosis or evaluation from a medical or mental health provider, it can give you insight into your symptoms, and it might just be the first step to getting the help that you need. The Mind Diagnostics Schizophrenia test is fast, free, and confidential to take. Although Schizophrenia can impact people of all age groups, the Mind Diagnostics Schizophrenia test is for those aged 18 and older.

To take the Mind Diagnostics Schizophrenia test, click the following link or copy and paste it into your browser: https://www.mind-diagnostics.org/Schizophrenia-test.