Psychosis is a syndrome characterized by features of reality distortion such as delusions and hallucinations. It may occur as a primary mental disorder or secondary to a medical or neurological illness or substance abuse. Several genetic, environmental, and protective risk factors have been identified and require further study. Neurobiological damage at the onset of schizophrenia is the most active and destructive. Therefore, it is important to detect the prodromal phase of psychosis so that interventions can be started early and the onset of psychosis delayed. Herein, we review the relevant epidemiological data on psychosis, particularly in Saudi Arabia. In addition, the risk and protective factors of psychosis will be discussed. Recent findings have shown that psychosis development is affected by genetic and environmental factors. Psychotic disorders are considered a cause of disability and are, therefore, a substantial economic burden. Consequently, it is important to try and detect the psychosis in its prodromal stage, where intervention may slow its progression and improve general wellbeing. Several tools have been identified to screen for the prodrome of psychosis, one of which is the prodromal questionnaire-brief version. This has been shown to be a promising tool that can be self-administered by the patient in contrast to long interview-based tools, which are time-consuming and require a physician to perform. Despite the limited evidence in the literature, there have been significant improvements in the outcomes of patients with psychosis when treated in the prodromal period. In summary, this article provides psychiatrists and researchers with an overview of psychosis, its risk factors, the prodromal stage of psychosis, tools to detect the prodromal phase, and potential treatments during this phase.

Key Clinical MessageWe present a case of a married man, known case of schizophrenia and tuberous sclerosis, who presented with delusion of pregnancy along with other psychotic symptoms. This type of delusion can be attributed to wish fulfillment as the patient has been married for seven years without being able to conceive.