Substance-Induced Psychosis and Co-occurring Psychotic Disorders

Abstract

Distinguishing between substance-induced psychosis (SIP) and a primary psychotic illness in the emergency setting can be difficult but important for making treatment and disposition decisions. Many different substances can cause psychosis during periods of intoxication, withdrawal, or both. In the acute setting, a thorough yet targeted clinical history with a review of certain objective findings is a strategy for differentiating between SIP and a primary psychotic disorder with or without comorbid substance use. Specific behavioral and pharmacologic interventions are necessary for treating agitation and psychosis, occurring either in the setting of SIP or primary psychotic disorders.