Korsakoff Psychosis: Exploring Korsakoff’s Syndrome

In general, different types of psychosis come with varying symptoms and presentations. One such type is Korsakoff psychosis, a unique result of medical challenges, often connected to a brain disorder called Wernicke-Korsakoff syndrome. This condition can involve typical symptoms of psychosis like hallucinations and delusions, as well as memory loss, confusion, apathy, and disorientation. Korsakoff psychosis usually requires medical care. Understanding this form of psychosis can lead to early intervention and a more comprehensive understanding of treatment options.

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What is psychosis? 

Symptoms of psychosis can include the following: 

• Hallucinations (sensory perceptions that are not genuinely occurring) 

• Delusions (firmly held, false beliefs that are difficult to change) 

• Disorganized thinking, behavior, and speech

• Confusion and suspiciousness

• Paranoia 

• Illogical thought patterns

• Low mood or emotional numbness

• Sleep difficulties 

• Personality changes

• Changes in professional, educational, and social performance 

• Thoughts of harm to oneself or others

What is the Korsakoff type of psychosis? 

Korsakoff psychosis, also referred to as Korsakoff amnestic syndrome, is a complication of a medical condition called Wernicke encephalopathy. 

In the Diagnostic and Statistical Manual for Mental Disorders, Fifth Edition (DSM-5), Korsakoff psychosis is classified as an alcohol-induced major neurocognitive disorder, not a schizophrenia spectrum or psychotic disorder.

Severe alcoholism tends to be a common underlying condition for Wernicke encephalopathy and Korsakoff psychosis. 

This type of psychosis can involve typical symptoms associated with a break from reality, like hallucinations and delusions, but can also cause symptoms like the following: 

• Retrograde and anterograde amnesia

• Apathy and bland affect

• A lack of response to external events, including those that are dangerous 

• Decreased initiative

• Bewilderment 

• A tendency to hyperfocus on seemingly random memories that are not related to current circumstances

• Confabulation, a type of memory error in which a person fills in memory gaps with distorted, fabricated, or misinterpreted information

• Disorientation to time 

Because this type of psychosis is normally caused by a medical illness and alcohol withdrawal, symptoms are often more challenging to treat and may be longer-lasting than typical psychosis symptoms. The clinical diagnosis leading to this form of psychosis usually causes permanent brain damage, which can prolong mental health challenges.   

Causes of Korsakoff psychosis 

The only cause of Korsakoff’s psychosis is Wernicke encephalopathy or Korsakoff syndrome. Wernicke encephalopathy is an acute neurological condition identified by a doctor through diagnostic testing that causes symptoms like the following: 

• Confusion 

• Memory loss (amnesia) 

• Vitamin deficiency 

• Thiamine deficiency 

• Personality changes

• Brain lesions 

• Permanent brain damage 

Wernicke’s disease and acute Wernicke encephalopathy are medical emergencies and can be fatal. These conditions are often caused by chronic alcoholism and alcohol withdrawal.

Wernicke’s disease typically causes dangerous neurological symptoms in several brain regions and can have severe consequences over a prolonged period. In some cases, a nerve cell infection may develop after initial symptoms subside. Individuals who receive immediate care from a doctor to treat Wernicke-Korsakoff syndrome and any resulting psychosis may see improved outcomes. 

Support options for psychosis 

A psychotic episode is a mental health emergency and frequently requires acute care. Below are a few treatment options people may consider when experiencing psychosis. 

Crisis interventions 

Hotlines and mental health crisis centers can be helpful when an individual is experiencing an active psychotic episode. You can also go to your local hospital emergency department to talk to them about your symptoms. Hospital staff are normally trained to screen for psychosis and other mental health emergencies. 

Because Korsakoff psychosis is typically caused by a medical illness, people with this symptom may benefit most from medical care provided by a supportive team of doctors, nurses, and mental health professionals. Doctors may administer thiamine and magnesium and ensure the patient is adequately hydrated.

Support groups

Those who have experienced psychosis may believe they are alone in their experiences. Reaching out to a support group for psychosis to connect with people who have had similar experiences may be helpful. 

To find a support group, the Schizophrenia & Psychosis Action Alliance (S&PAA) offers a network of online and in-person groups that people with psychosis and schizophrenia can join. 

Family members of people with psychotic disorders can also find support groups on this site. Because caregiving for someone who experiences psychosis can be challenging, caregiver groups often address topics like compassion fatigue and burnout. 

Therapy

Therapy can be another helpful tool for people with psychosis, generally allowing them to speak with a professional to find a support system and create a safety plan for active symptoms. However, some people may face challenges seeking this type of support, especially while receiving medical care or requiring home care. In these cases, online therapy platforms like BetterHelp may be more convenient.

With online therapy, clients can attend sessions from home or another location with an internet connection via phone, video, or live chat. In addition, online platforms may offer additional resources like worksheets and journaling prompts that can help people participate more actively in their treatment plans. 

Studies usually support the effectiveness of online therapy for psychosis. A 2021 study reported that online therapy for people with psychosis could be both feasible and effective, and individuals typically experienced reduced delusion severity after completing the online intervention. However, those with Korsakoff psychosis will likely require in-person medical care. Still, online therapy may be a helpful addition to treatment.