268 Brief Psychotic Disorder (298.8)

DSM-IV-TR criteria

• A. Presence of one or more of the following:
  • Delusions
  • Hallucinations,
  • Disorganized speech (e.g., frequent derailment or incoherence)
  • Grossly disorganized or catatonic behavior
  • NOTE:* You should not include these symptoms if they are a culturally sanctioned response pattern.
• B. Duration of an episode of the disturbance is at least 1 day but less than 1 month, with eventual full return to premorbid level of functioning.
• C. The disturbance is not better accounted for by a Mood Disorder With Psychotic Features, Schizoaffective Disorder, or Schizophrenia and is not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition
• Specify if:
  • With Marked Stressor(s) (brief reactive psychosis): if symptoms occur shortly after and in response to events that, singly or together, would be markedly stressful to almost anyone in similar circumstances in the person’s culture
  • Without marked Stressor(s): if psychotic symptoms do not occur shortly after, or are not apparently in response to events that, singly or together, would be markedly stressful to almost anyone in similar circumstances in the person’s culture
  • With Postpartum Onset: onset within 4 weeks postpartum

Associated features

People with brief psychotic disorder usually experience emotional problems as well as huge amounts of confusion. They usually experience dramatic shifts of intense mood.

The level of impairment for this disorder may be brief, but it could also be very severe. The individual needs to be protected from the consequences of cognitive impairment, acting on the basis of delusions, and poor judgment. Because of this, supervision may be required. Also, supervision is needed in order to make sure that nutritional and hygienic needs are met and kept.

There is a high risk of suicide among younger teens who have this psychotic disorder and a highly increased risk of mortality among them also.

Personality disorders such as paranoid, schizotypal, and borderline personality disorder, along with others, may increase the development of brief psychotic disorder.

People who suffer from this disorder often have just lost a loved one or recently experience some form of intense grief. Afterward, they might experience extreme symptoms such as hallucinations or delusions, memory loss/impairment, confusion, and other physical changes (sleeping and eating patterns etc.).

Child vs. adult presentation

Brief psychotic disorder is very rarely seen in children. On average, it usually appears more in adolescence or early adulthood. The age of onset is usually around late 20’s to early 30’s.

Gender and cultural differences in presentation

Gender differences in brief psychotic disorder are rarely seen. There is, however, some evidence of a slightly higher rate of brief psychotic disorder in women than men.

Cultural differences, on the other hand, are very popular. For example, if a patient reported hearing voices in the United States, they may be put on medications for brief psychotic disorder. In other cultures, however, if a patient hears voices it could be seen as a normal thing. It is part of their culture and their community as a whole may be experiencing the same phenomenon.

Epidemiology

The epidemiology is usually considered uncommon. The exact prevalence, and/or incidence is not fully known, therefore making the cause of brief psychotic disorder a mystery as of right now.

Etiology

The cause of brief psychotic disorder, as stated earlier, is unknown. People who have this disorder may have a psychological or even a biological vulnerability to developing the disorder or simply the symptoms of the disorder. Having other psychotic disorders makes the patient more prone to develop brief psychotic disorder.

Empirically supported treatments

There is no known way to prevent this disorder.

A few common medications used are Thorazine, Prolixin, Haldol, and Trilafon.The prognosis becomes better the soon the disorder is diagnosed and treatment can begin.

If the symptoms are severe, a person may be admitted into a hospital to try and treat brief psychotic disorder. Other than this, psychotherapy and medications are used often. Psychotherapy is a method used to help the patient deal with, or cope with the disorder and learn how to handle the stressor that signaled it. The medications that are given to the patients are called anti-psychotic drugs. The anti-psychotic drugs help decrease the symptoms of brief psychotic disorder and also may eliminate the symptoms.