Psychosis from a medical condition

What it is

Psychotic symptoms can be the direct result of a medical condition affecting the brain. Infections (including those affecting the brain), epilepsy, HIV, stroke, brain tumours, thyroid disease, severe vitamin deficiencies and metabolic disturbances can all produce hallucinations or delusions. This is why a first episode of psychosis always warrants a medical assessment, not only a psychiatric one.

Recognising a medical cause changes everything: the priority becomes treating the underlying condition, which may resolve the psychosis entirely. Missing it means treating only the symptom while the cause continues.

How it is treated

The first step is diagnosing and treating the medical cause: controlling the infection, managing the epilepsy, starting or adjusting HIV treatment, correcting the thyroid or the deficiency. Short-term antipsychotic medication may be used alongside to manage distressing symptoms and keep the person safe while the underlying treatment takes effect.

This category is a reminder of how closely body and mind are linked, and of why mental health care belongs inside general health care, not separate from it, particularly in settings where one clinic visit must do a great deal.

Psychosis from a medical condition in the African context

This is especially important here, because several of the medical conditions that can cause psychosis, including infections that affect the brain, epilepsy, HIV, severe vitamin deficiencies, and thyroid disease, are present in the region, and a first episode of psychosis is very often understood as bewitchment, a curse, or possession and taken for spiritual help while a treatable medical cause goes unaddressed. The key message is not to set spiritual belief against medicine, but to ensure that any first psychosis, particularly with physical signs such as fever, fits, confusion, weakness, or weight change, receives prompt medical assessment, because finding and treating the cause can resolve the psychosis. Mental and physical care belong together.

What families can do

• Treat any new psychosis, especially with physical signs such as fever, fits, confusion, weakness, or weight change, as a reason for urgent medical assessment.
• Mention all illnesses, infections, and medicines, which help find a treatable cause.
• Support treatment of the underlying medical condition, alongside any short-term treatment for the psychotic symptoms.
• Keep the person calm and safe, and seek urgent help where needed.
• Spiritual support can continue alongside, but should not replace prompt medical care.