Some patients may experience a psychotic episode following surgery. Identifying the cause can help guide effective management and recovery.
Neurological or psychological disorders associated with psychosis:
(1) bipolar disorder
(2) pre-existing psychosis
(3) paraneoplastic neurologic disorders
(4) stroke
(5) seizures
Procedures with increased risk:
(1) cardiac surgery, especially after use of cardiopulmonary bypass (which is associated with perioperative stroke)
(2) neurosurgery (temporal lobe, deep nerve stimulator)
(3) abortion or cesarean section (which may overlap with postpartum psychosis)
Drugs:
(1) corticosteroids
(2) indomethacin
Medical disorders:
(1) hypothyroidism or hyperthryoidism
(2) homocystinuria
(3) other inherited metabolic disorders
Other risk factors:
(1) stay in the ICU ("ICU psychosis")
The diagnosis requires exclusion of delirium and other conditions.
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Specialty: Psychiatry, Surgery, general, Anesthesiology
