Acute Psychosis: ICD-10 Code, Symptoms, And Treatments

Acute psychosis is a mental health condition characterized by a sudden onset of symptoms, such as hallucinations and delusions, that lead to a loss of touch with reality. Acute psychosis may be more common in young adults, affecting three out of 100 young adults; however, people of any age can experience a psychotic episode. When diagnosed and treated early, it’s possible for individuals who experience acute psychosis to recover. 

Mental health professionals use an international system (called the ICD-10) to classify the symptoms and diagnosis of medical conditions, including acute psychosis. In this article, we’ll explore how the ICD-10 is used to diagnose acute psychosis, while learning about the symptoms of acute psychosis as well as available treatments.

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What is the ICD-10? 

The ICD-10 is the 10th revision of the International Classification of Diseases, a coding system that can provide a consistent way to record, report, and monitor a variety of symptoms as well as diseases and conditions. Beyond categorizing diseases, this system can also provide a format for health professionals to report causes of death. 

Published by the World Health Organization (WHO), the ICD contains numerous elements for health professionals, such as a structure for the classification, modification, and selection of diseases and causes of death. This structure generally translates these diseases and causes into medical codes. 

The ICD may provide numerous benefits, including consistent and accurate disease reporting, potentially increasing the usefulness of statistics by consolidating conditions and making it easier to select a single cause of disease or death from a series of potential conditions. 

In 2022, the latest revision of the ICD, the ICD-11, came into effect as the standard version used by the World Health Organization. However, some countries or areas may still use the ICD-10. As such, it may be beneficial to know the ICD-10 codes for various conditions, including acute psychosis.  

What is the acute psychosis ICD-10 code?

While a number of conditions in the ICD-10 can involve psychosis, the ICD-10 code that may relate most closely to acute psychosis is F23.2, which refers to acute schizophrenia-like psychotic disorder. This disorder may display similar psychotic symptoms to schizophrenia, but it usually lasts for less than one month. 

The ICD-10 clarifies that if schizophrenic symptoms persist, then the diagnosis should be changed to F20 (schizophrenia). However, the ICD-10-CM (the clinical modification version of the ICD-10) may have a code specifically for unspecified psychosis not due to a substance or known physiological condition. This code, which is often used for billing purposes, is F29. 

What is acute psychosis?

Acute psychosis can be seen as the second phase of a phenomenon known as psychosis that can alter how an individual thinks, behaves, and perceives reality. The initial manifestation of psychosis, sometimes referred to as first-episode psychosis, may seem confusing and disturbing. 

Manifestations of psychotic symptoms, commonly referred to as episodes, may occur more than once, depending on the reason a person is experiencing psychosis. While everyone’s experience with psychosis can differ, psychotic episodes typically occur in three phases:

• Phase 1: Sometimes referred to as the prodrome phase, the initial stage of psychosis can be difficult to notice. Changes in thought patterns and behaviors may start subtly and increase over time. Some common signs of the prodrome phase of psychosis may include difficulty concentrating, feelings of anxiety and depression, lack of motivation, withdrawal from loved ones, and sleep disturbances. 
• Phase 2: Known as the acute phase or the “critical period,” the second phase of psychosis is often when symptoms begin to clearly present themselves and increase in severity. These symptoms may include delusions, hallucinations, and confused thinking or speech. The acute phase of psychosis can create significant distress and may cause a person to act in a way that concerns friends or family. 
• Phase 3: Often referred to as the recovery phase, the final stage of psychosis typically involves a decrease in symptoms. This may be due to treatment, which, if effective, could prevent a person from experiencing additional episodes of psychosis. However, it can be important to note that there may still be residual symptoms during the recovery phase, potentially including delusional thought patterns and flat affect. 

What are the symptoms of acute psychosis?

Individuals in the acute phase of psychosis may experience a variety of symptoms, including:

• Delusions: Individuals experiencing psychosis may hold beliefs that can be proven false or not based in reality. In most cases, individuals will not doubt the legitimacy of these beliefs, even when presented with evidence to the contrary. Delusions can fall into several categories, which may include mood-congruent (those that are related to a manic or depressive mood state), mood-incongruent (those that aren’t related to a specific mood state), bizarre (those that are most likely impossible), and non-bizarre (those that may be possible).
• Hallucinations: People experiencing psychosis may hear, see, taste, feel, or smell things that they believe are real, but are not actually there. These are generally known as hallucinations, false sensory experiences that can range from seeing a deceased loved one to holding conversations with disembodied voices. Similar to delusions, individuals with psychosis often believe the hallucinations they are seeing or feeling are real, which can have an impact on how they behave. 
• Changes in speech or thinking: Psychosis may result in disordered thought and speech patterns. These can manifest in a variety of ways, including through racing thoughts, rapid speech, erratic changes in conversation topics, or sudden pauses in speech. Disordered speech patterns may also involve the use of words that don’t exist or have no meaning, while disordered thought patterns may not follow a clear line of logic or adhere to reality. 

How is acute psychosis treated? 

Depending on the severity of an individual’s acute psychosis, treatments may range from emergency psychiatric or medical care to a regimen of antipsychotic medication and various therapeutic approaches. There are several common recommendations for psychosis treatment, including those discussed below.

Early intervention teams 

Those experiencing their first episode of psychosis may be supported by an early intervention team. These teams can assess a person’s needs, provide therapy, administer medication, and connect individuals to any necessary social, educational, or occupational intervention specialists.

Antipsychotics

Antipsychotic medication is usually seen as the first line of treatment for psychosis. These medications typically work by blocking dopamine receptors, as dopamine is a neurotransmitter that may be at least partially responsible for the symptoms of psychosis. While these medications may not eliminate symptoms completely, they may reduce delusions, hallucinations, confused speech and thinking, and several other key components of this condition. 

While antipsychotics may be effective, they can also cause side effects, including muscle pain, twitches, and spasms, as well as restlessness, shaking, trembling, constipation, drowsiness, and dry mouth. Be sure to inform your prescribing provider if you experience any side effects, and always consult your doctor or psychiatrist before starting, stopping, or changing the way you take medication. 

Talk therapy

Several forms of talk therapy, including family therapy and cognitive behavioral therapy, may also be helpful for individuals who have experienced psychosis.

Family therapy, or family intervention, can help both an individual with psychosis and their loved ones. Because psychosis can impact a person’s support system, this type of therapy may help families learn shared coping methods or ways to support those experiencing this condition. Family therapy sessions may involve discussing psychotic symptoms, reviewing available treatments, or creating a plan for future episodes. 

Cognitive behavioral therapy (CBT) typically focuses on the individual experiencing psychosis, specifically the thoughts, feelings, and behavioral patterns related to their condition. A CBT provider may help an individual understand what is occurring during an episode of psychosis, which elements of psychosis cause distress, and potential ways to cope. 

However, in-person therapy may not be accessible, convenient, or appropriate for everyone. Some individuals may live in an area without enough mental health providers. Others may not be comfortable commuting to a face-to-face therapy session or discussing the challenges of psychosis in person. In addition, some people may prefer to attend sessions from the comfort of their own homes or through online chat, phone call, or video call. In these cases, it may be beneficial to try alternative therapeutic formats, such as online therapy. Please note that online therapy may not be suitable for individuals experiencing acute psychosis, but it may be a valid choice for those in the prodromal or residual stages.

Online forms of therapy may have similar levels of effectiveness to those delivered in person. While there aren’t yet many studies evaluating the efficacy of online therapy specifically for psychosis, virtual therapy can effectively treat a variety of mental health challenges and concerns. As it can be common for depression, anxiety, and stress to co-occur with and exacerbate psychotic symptoms, addressing these difficulties through online therapy may also have a positive impact on psychosis. 

Takeaway

The ICD-10, or International Classification of Diseases, 10th Edition, is a system by which diseases and causes of death can be classified, reported, and coded by medical professionals. This system may be used for a variety of purposes, including record-keeping, statistics, and cause-of-death certificates. Acute psychosis, a condition that can affect how a person thinks and behaves, may be classified by the ICD-10 code F23.2. Psychosis may involve multiple stages, with acute psychosis constituting the second stage. This condition can have several symptoms, including delusions, hallucinations, and changes in speech or thinking. While everyone’s experience with psychosis can be different, treatments may include early intervention, antipsychotic medication, and various forms of therapy, which may be completed in-office or online.