Brief Psychotic Disorder

Definition

A brief psychotic disorder is an uncommon psychiatric condition characterized by sudden and temporary periods of psychotic behavior, such as delusions, hallucinations, and confusion. Symptoms can last as little as a day or as long as a month, but may be severe enough to put the person at increased risk of violent behavior or suicide. A majority of cases present for the first time when an individual is in their 20s or 30s, although onset can occur at any age. Brief psychotic disorder is differentiated by its limited duration and is not triggered by drugs or alcohol abuse. Most often, brief psychotic disorder does not indicate the presence of a chronic mental health condition.

Symptoms

Symptoms of brief psychotic disorder are similar to those of schizophrenia and, in addition to delusions and hallucinations, can include sudden and extreme mood changes, nonsensical or disordered speech, inability to perform normal self-care, social and professional dysfunction, sleep problems, and disorganized or even catatonic behavior. Women are more likely than men to develop brief psychotic disorder, which has been known to develop during or soon after pregnancy. Once symptoms subside and the episode is over, the person’s life goes back to normal. Most people who develop brief psychotic disorder experience just a single episode but for some others, stressful situations may trigger more episodes in the future. Although the prognosis for brief psychotic disorder is generally good, an initial psychotic episode may be the first sign of a chronic mental health condition such as schizoaffective disorder, schizophrenia, or a mood disorder with psychotic symptoms. The diagnosis of brief psychotic disorder is generally reevaluated if symptoms persist after a month has passed.

Causes

The cause of brief psychotic disorder is unclear, but major stress or trauma — such as the death of a loved one, assault, or natural disaster — can trigger an episode. As with other conditions on the “schizophrenic spectrum,” there may be a genetic, biologic, environmental, or neurological basis to this disorder. Brain abnormalities have been found in people with psychotic disorders; some appear to be present before symptoms first appear, while other abnormalities have been recorded after the onset of symptoms. Brief psychotic disorder tends to run in families and can appear alongside life-threatening conditions, like delirium.

Treatments

Generally, a medical or psychiatric professional will interview the person to rule out any other physical or mental health condition that exists simultaneously or could be causing the symptoms. Antipsychotic medications and, if necessary, antidepressants may be prescribed to help manage symptoms, and the person may need to be supervised at all times to ensure they don’t harm themselves or others. Short-term psychotherapy can help a person understand and recover from brief psychotic disorder, manage their medications and learn to cope with stress. Those who fail to seek treatment are more likely to see a future recurrence of brief psychotic disorder with all of the symptoms.

References

American Psychiatric Association. Understanding Mental Disorders: Your Guide to DSM-5. 2015. American Psychiatric Publishing.

MedlinePlus. Brief Psychotic Disorder. https://medlineplus.gov/ency/article/001529.htm

Pantelis C, Velakoulis D, McGorry PD, et al. Neuroanatomical abnormalities before and after onset of psychosis: a cross-sectional and longitudinal MRI comparison. Lancet. Jan 2003;361(9354): 281-288. http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(03)12323-9/abstract

Fusar-Poli P, Cappucciati M, Bonoldi I, et al. Prognosis of brief psychotic episodes: A meta-analysis. First published online March 2016. JAMA Psychiatry. http://jamanetwork.com/journals/jamapsychiatry/fullarticle/2481383

Last reviewed 10/11/2017