Brief Psychotic Disorder
A brief psychotic disorder is a psychiatric condition characterized by sudden and temporary periods of psychotic behavior, such as delusions, hallucinations, and confusion. Symptoms can endure for only one day or for as long as one month, but they may be severe enough to put the person at increased risk of violent behavior or suicide. Although onset can occur at any age, the majority of cases present for the first time when an individual is in their 20s or 30s. Brief psychotic disorder is differentiated from other disorders in which psychosis occurs by its limited duration, and it is not triggered by drugs or alcohol abuse. In most cases, brief psychotic disorder does not indicate the presence of a chronic mental health condition.
According to the DSM-5, symptoms of brief psychotic disorder may include:
- Delusions and hallucinations
- Sudden and extreme mood changes
- Nonsensical or disordered speech
- Disorganized behavior
Other signs may include:
- Memory problems
- Beliefs that may seem bizarre
- Changes in sleep, eating, hygiene
Women are more likely than men to develop brief psychotic disorder, especially postpartum. The DSM-5 classifies one subtype of brief psychotic disorder as psychosis with onset within one month of giving birth. Most people who develop brief psychotic disorder experience only one episode and are able to resume all activities with no permanent symptoms or impairment. People with certain personality disorders have an elevated risk of experiencing a brief psychotic episode, as are those who have experienced trauma or severe stress. It is important to understand that the prognosis for brief psychotic disorder is generally good. However, 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 for more than one month.
Brief psychotic disorder does not normally recur. Certainly, if the symptoms last longer than a month, health professionals may assess if there is another illness or disorder, such as schizophrenia.
Brief limited intermittent psychotic symptoms, known as BLIPS, are moderate to severe manifestations of psychosis. The symptoms can happen before the onset of severe mental illness. Symptoms for brief and limited psychosis last no more than one week. There are also brief intermittent psychosis symptoms, or BIPS, where symptoms last less than three months.
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 disorders on the psychotic spectrum, there may be a genetic, biologic, environmental, or neurological basis for this episode. Neurological 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.
Extreme or intense stress can cause brief psychosis that lasts for less than one month. The person normally has no other mental illness or medical condition.
Stress, drugs, and other substances can indeed exacerbate brief psychosis. People with a family history of psychosis are particularly at higher risk.
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 after a first psychotic episode are more likely to see a future recurrence of brief psychotic disorder or to subsequently be diagnosed with a chronic disorder on the psychotic spectrum.
Brief psychotic disorder generally has a good prognosis. It concludes its course in a short period of time, within a month. It is normally sudden-onset and symptoms are not lasting. People with no previous history of psychiatric illness tend to have better outcomes.