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Episódios Psicóticos: causas e tratamento em Lisboa

PSYCHOTIC EPISODES - Treatment in Lisbon

Emergency psychiatric assessment and specialised clinical intervention in Lisbon

WHAT IS A PSYCHOTIC EPISODE?

Avaliação neuropsiquiátrica de episódios psicóticos — NeuroPsyque Lisboa

A temporary break with reality

A psychotic episode is characterised by a profound change in the way the brain processes information, leading to a temporary loss of contact with reality. It is not, in most cases, a permanent condition, but rather an acute state caused by severe neurochemical dysregulation, which needs immediate medical intervention to protect the brain and the patient's well-being.

Most common manifestations

  • Hallucinations
    Perceiving things that don't exist, such as hearing voices or seeing unreal images, experiencing them vividly and absolutely.
  • Delusions
    Obsessive beliefs, often of a persecutory or grandiose nature, which are immune to logic or evidence to the contrary.
  • Disorganised Thinking
    Very confusing speech, jumping between topics with no apparent logical connection, making communication and coherence difficult.
  • Behavioural changes
    Extreme agitation, unexpected attitudes, sudden isolation or, in some cases, motor paralysis (catatonia).

CAUSES AND TRIGGERS

Primary Psychiatric Diseases

A psychotic episode can be the first sign of Schizophrenia, Schizoaffective Disorder, or a severe episode of Bipolar Disorder or Major Depression with psychotic symptoms.

Psychiatric

Induction by Substances

The use of psychoactive drugs, such as cannabis (especially in young people with a predisposition), cocaine, amphetamines or hallucinogens, is a very common trigger.

Toxic

Organic and Neurological Causes

Brain tumours, infections of the central nervous system, temporal lobe epilepsy or autoimmune diseases that directly affect the brain.

Neurological

Stress and Extreme Trauma

Peaks of acute stress, prolonged sleep deprivation or deeply traumatic life events can lead to a "brief reactive psychosis".

Environmental
Estudo do cérebro na avaliação de causas orgânicas para a psicose

Rigorous psychiatric assessment is crucial to distinguish a drug-induced psychosis from a chronic psychiatric illness.

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EFFECTIVENESS IN TREATMENT AND PREVENTION
OF PSYCHOTIC EPISODES

Rapid intervention and psychiatric stabilisation to prevent cognitive impairment and relapses

65%
of patients with a first psychotic episode achieve a significant clinical response by the 16th week of antipsychotic treatment
75%
reduction in the risk of new episodes when a strict clinical follow-up plan is maintained
3×
greater preservation of cognitive functions when the first psychotic episode is treated early
90%
of brief episodes induced by acute stress resolve completely without developing into a chronic illness

* Time without treatment (Duration of Untreated Psychosis) is the most critical factor. Acting quickly protects the brain.

Sources: clinical data, Agid et al. (2003), Int J Neuropsychopharmacol - cumulative response rate in first psychotic episode with olanzapine/risperidone (65% at week 16); NIH review on antipsychotics and maintenance of remission in first psychotic episode; DSM-5 and clinical literature on Brief Psychotic Disorder (complete remission ≤1 month by diagnostic definition).

TECHNOLOGY AND THE CLINICAL ENVIRONMENT

Estudo neurofisiológico na avaliação de episódios psicóticos
Estimulação Magnética Transcraniana (EMT) complementar
Apoio clínico na recuperação de crises psicóticas
Acompanhamento e regulação emocional pós-crise
tDCS - Estimulação Eléctrica Transcraniana
Mapeamento Cerebral (qEEG) e diagnóstico diferencial
Clínica Lisboa
Ondas Cerebrais
Fisiologia
Salas de consulta psiquiátrica e psicoterapêutica
Espaço Clínico NeuroPsyque - Intervenção segura e confidencial

THE URGENCY OF EARLY CLINICAL INTERVENTION

A psychotic episode is a neuropsychiatric emergency. The longer the brain remains in a state of active psychosis, the greater the risk of prolonged suffering, risky behaviour and long-term neurocognitive damage. It is common for the affected person to be unaware that they are ill, which makes it crucial for family and carers to act quickly to seek medical help.

💡 A single psychotic episode does not dictate the future. When treated immediately and compassionately, it is possible to reverse the crisis and resume a fully functional life.

At NeuroPsyque, we offer an empathetic, rigorous psychiatric assessment in complete privacy, focused on differential diagnosis to rule out organic or toxic causes. We also offer psychotherapeutic counselling for the recovery phase and family support. Our aim is to break the stigma, stabilise the clinical picture and guarantee the patient a safe return to reality.

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Frequently Asked Questions

FAQ's about Psychotic Episodes

Does a psychotic episode mean that the person has schizophrenia?
Not necessarily. Schizophrenia is just one of many possible causes. A psychotic episode can be transient, triggered by drug use, extreme sleep deprivation, severe bereavement or mood disorders (major depression or bipolar disorder). The final diagnosis always depends on the duration and evolution of the symptoms.
How should I act with someone who is in an active psychotic episode?
Stay calm and use a soft tone of voice. Don't argue or try to prove to the person that what they see or hear isn't real (for their brain, it's an absolute reality). Make sure the person is in a safe environment, remove excessive stimuli (noise, bright lights) and seek medical help immediately.
Does antipsychotic medication simply erase the voices or delusions?
Modern antipsychotics are highly effective, but their action is not immediate. Agitation and anxiety are usually reduced within the first few days, but complete remission of hallucinations and delusions can take a few weeks to stabilise. Patience and strict adherence to therapy are crucial.
Does the person realise they're going through a crisis?
During the acute phase, it is very rare. Most patients suffer from "anosognosia" - the neurological inability to recognise that they are ill and that their perceptions are altered. This makes the family's role essential in ensuring that the person reaches a medical assessment, and in ensuring emotional stability.
Can cannabis use really cause psychosis?
Yes. Cannabis consumption (especially modern strains with a high THC concentration) is one of the most dangerous toxic triggers for psychotic episodes in young brains or those with a genetic predisposition, and can anticipate or trigger irreversible chronic conditions that might never manifest.
Is full recovery possible after a psychotic episode?
Yes. With timely intervention (Psychiatry), a large percentage of patients fully recover their previous functionality. The post-psychotic phase can involve a period of mental exhaustion e depressive symptoms (a "mourning" for the experience lived), and the psychotherapeutic counselling a key player in this reconstruction phase. Contact us if you need guidance.