Brief Psychotic Disorder

In brief psychotic disorder, the patient experiences a full psychotic episode that is short-lived. It can be temporally related to some stressor or occur postpartum, but is also seen without any apparent antecedent.

Epidemiology


There is insufficient data available to determine prevalence and sex ratio.

Etiology

Etiology is unknown. However, it seems to be associated with borderline personality disorder and schizotypal personality disorder.

Clinical Manifestations

History and Mental Status Examination
In brief psychotic disorder, the patient develops psychotic symptoms that last for at least 1 day but no more than 1 month, followed by eventual return to premorbid functioning. Patients can exhibit any combination of delusions, hallucinations, disorganized speech, or grossly disorganized behavior. There are three recognized subtypes: with marked stressors (formerly known as brief reactive psychosis), without marked stressors, and postpartum. Patients with the postpartum subtype typically develop symptoms within 1 to 2 weeks after delivery that resolve within 2 to 3 months.

Differential Diagnosis
It is important to rule out schizophrenia, especially if the disorder worsens or persists for more than a month (except for postpartum psychosis, which may last 2 to 3 months). A mood disorder such as mania or depression with psychotic features must be ruled out.

Management

Hospitalization may be necessary to protect the patient. Treatment with antipsychotics is common, although the condition is by definition self-limited and no specific treatment is required. The containing environment of the hospital milieu may be sufficient to help the patient recover.

KEY POINTS
1. Brief psychotic disorder is characterized by typical psychotic symptoms.
2. The condition is short-lived, lasting from 1 to 30 days.
3. It can be preceded by a stressor or can be postpartum.
4. It may occur without an antecedent.
5. The condition is self-limited.

Provided by ArmMed Media
Revision date: July 6, 2011
Last revised: by Janet A. Staessen, MD, PhD