Acute Psychoses

  • Arthur BarskyIII
Part of the Critical Issues in Psychiatry book series (CIPS)


In caring for the acutely psychotic patient, the psychiatrist is similar to a general medical physician. He uses the traditional methods of clinical medicine: (1) data gathering (history, physical examination, laboratory investigation), (2) differential diagnosis, and (3) treatment. The acutely psychotic patient is presumed to be suffering a pathological process that has a specific treatment. The doctor’s role tends to be more authoritarian than in many other areas of psychiatry—the psychiatrist must often take control of the situation, prescribing and proscribing rather than negotiating. Because judgment is impaired and decisions unrealistic, the acutely psychotic patient tends to play a relatively minor part in determining his emergency care. Although the psychiatrist values his alliance with the patient, with an acute psychotic there may be no real alliance established, or it may be subject to violation if good care must override patient wishes.


Psychotic Patient Acute Psychosis Affective Disturbance Subacute Bacterial Endocarditis Functional Psychos 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Shneidman ES, Farberow NL: Clues to Suicide. New York, McGraw-Hill, 1957.Google Scholar
  2. 2.
    Reich P, Kelly MJ: Suicide attempts by hospitalized medical and surgical patients. N Engl J Med 294: 298–301, 1976.PubMedCrossRefGoogle Scholar
  3. 3.
    Peralson GD: Psychiatric and medical syndromes associated with phencyclidine (PCP) abuse. Johns Hopkins Med J 148: 25–33, 1981.Google Scholar
  4. 4.
    Lion JR: Evaluation and Management of the Violent Patient. Springfield, 111, Charles C Thomas, 1972.Google Scholar
  5. 5.
    Keller MB, Manschreck TC: The biologic mental status examination. Higher intellectual functioning, in Lazare, A (ed): Outpatient Psychiatry: Diagnosis and Treatment. Baltimore, Williams & Wilkins, 1979, pp 203–214.Google Scholar
  6. 6.
    Folstein MF, Folstein SE, McHugh PR: Minimental state—A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 12: 189–198, 1976.CrossRefGoogle Scholar
  7. 7.
    Bender L: A visual-motor test and its clinical use. American Orthopsychiatric Association Research Monograph #3. New York, American Orthopsychiatric Association, 1938.Google Scholar
  8. 8.
    Hall RCW, Popkin MK, Devaul RA, et al: Physical illness presenting as psychiatric disease. Arch Gen Psychiatry 35: 1315–1320, 1978.PubMedCrossRefGoogle Scholar
  9. 9.
    Anderson WH: The physical examination in office practice. Am J Psychiatry 137: 1188–1192, 1980.PubMedGoogle Scholar
  10. 10.
    Carlson GA, Goodwin FK: The stages of mania. Arch Gen Psychiatry 28: 221–228, 1973.PubMedCrossRefGoogle Scholar
  11. 11.
    Schoonover SC: The practice of pharmacotherapy, in Bassuk EL, Schoonover SC, Gelenberg AJ (eds): The Practitioner’s Guide to Psychoactive Drugs, ed 2. New York, Plenum Publishing Corp, 1983.Google Scholar
  12. 12.
    Gelenberg AJ: The catatonic syndrome. Lancet 1: 1339–1341, 1976.PubMedCrossRefGoogle Scholar
  13. 13.
    Havens LL: Taking a history from a difficult patient. Lancet 1: 138–140, 1978.PubMedCrossRefGoogle Scholar
  14. 14.
    Anderson WH, Kuehnle JC, Catanzano DM: Rapid treatment of acute psychoses. Am J Psychiatry 133: 1076–1078, 1976.PubMedGoogle Scholar
  15. 15.
    Stern TA, Anderson WH: Benztropine prophylaxis of dystonic reactions. Psychopharmacology 61: 261–262, 1979.PubMedCrossRefGoogle Scholar
  16. 16.
    Khantzian EJ, McKenna GJ: Acute toxic and withdrawal reactions associated with drug use and abuse. Ann Intern Med 90: 361–372, 1979.PubMedGoogle Scholar
  17. 17.
    Showalter CV, Thornton WE: Clinical pharmacology of phencyclidine toxicity. Am J Psychiatry 134: 1234–1238, 1977.PubMedGoogle Scholar
  18. 18.
    Lazare A, Eisenthal S: A negotiated approach to the clinical encounter. I. Attending to the patient’s perspective, in Lazare A (ed): Outpatient Psychiatry: Diagnosis and Treatment. Baltimore, Williams & Wilkins, 1979.Google Scholar
  19. 19.
    Anderson WH, Kuehnle JC: Strategies for the treatment of acute psychosis. JAMA 229: 1884–1889, 1974.PubMedCrossRefGoogle Scholar

Copyright information

© Plenum Press, New York 1984

Authors and Affiliations

  • Arthur BarskyIII
    • 1
    • 2
  1. 1.Massachusetts General HospitalBostonUSA
  2. 2.Harvard Medical SchoolBostonUSA

Personalised recommendations