Brief Psychotic Disorder: Symptoms And Treatment

Brief psychotic disorder can be considered a type of temporary psychosis that usually lasts between one day and one month. Individuals experiencing brief psychotic disorder may have symptoms like delusions, hallucinations, disorganized thinking and speech, and disordered or catatonic behavior. Temporary psychosis may also occur in schizophreniform disorder, bipolar disorder, depression with psychotic features, substance use disorder, and some medical conditions. Brief psychotic disorder can usually be treated with a combination of medication and therapy alongside psychosocial interventions and social support.

An overview of psychosis and psychotic disorders

Psychosis generally refers to a set of symptoms characterized by a loss of contact with external reality, typically affecting how one thinks, speaks, behaves, and perceives the world around them. There are several psychotic disorders recognized in the Diagnostic and Statistical Manual of Mental Disorders (DSM-V), including:

• Schizophrenia
• Schizophreniform disorder
• Schizoaffective disorder (bipolar or depressive type)
• Delusional disorder
• Brief psychotic disorder 
• Substance or medication-induced psychosis
• Psychotic disorder due to another medical condition

While it isn’t a diagnosable condition, temporary psychosis is sometimes used to describe conditions like brief psychotic disorder, in which psychotic symptoms have a shorter duration. 

Most psychotic disorders emerge in the late teenage to early adult years. However, brief psychotic disorder’s median age of onset tends to be in the mid-30s. Psychosis associated with other factors, like physiological conditions, can emerge at different times. 

It is estimated that roughly 1.5% to 3.5% of the population will experience symptoms of a primary psychotic disorder at some point in their lifetime. Reliable estimates on the prevalence of temporary psychosis aren’t readily available, primarily because it is highly variable and can exist within different conditions, which may or may not be psychological.  

Recognizing psychotic symptoms: Potential signs of temporary psychosis

Psychotic symptoms often present differently between people and are typically influenced by a myriad of factors, such as age, background, culture, and life experiences. Individuals frequently experience profound changes in identity during psychosis, further affecting the nature of their symptoms. 

It may be prudent to note that many early psychosis symptoms mirror those of other disorders. As such, early intervention is often vital for accurate diagnosis and treatment. Certain behavioral changes may indicate warning signs of psychosis.

Changes in thoughts and speech

Individuals with psychosis often have odd thought patterns and beliefs that don’t coincide with reality, such as:

• An uncharacteristic preoccupation with religion, the occult, or unseen entities
• Thoughts that others are in love with them or hate them without reason
• An uncharacteristic preoccupation with a celebrity, TV series, or media personality

Cognitive symptoms like memory problems and diminished focus can be signs of emerging psychosis, but they can also be symptoms of depression, anxiety, and other psychological conditions. Cognitive symptoms might be associated with psychosis when they are accompanied by strange speech patterns, such as:

• Irrational, impulsive, or inappropriate statements
• Racing or reduced speech
• Disorganized, incoherent sentence structure
• Using odd or nonsensical words (sometimes referred to as “word salad”)

Changes in behavior

Sometimes, individuals with psychosis exhibit changes in behavior that are uncharacteristic or seemingly random. Examples can include:

• Significant decrease in daily function
• Uncharacteristic high-risk or reckless behaviors
• Notable diminishment in activity or hyperactivity
• Unusual or inappropriate reactions to external stimuli
• Deterioration of self-care and personal hygiene
• Agitated, spontaneous movements
• Strange gesturing or posturing
• Significant disturbances in sleep
• Uncharacteristic substance or alcohol use
• Self-harm or threatening to harm others

Changes in social behavior

Changes in social behavior can be attributable to other conditions, like social anxiety disorder or depression, but they may also signal the beginning of a psychotic episode. Changes in social behavior that may be seen as a warning sign of psychosis include:

• The avoidance of social activities or situations in which one may be required to communicate with others
• Uncharacteristic, inappropriate aggression
• Reclusiveness and isolation
• Extreme mistrust of others without cause
• A diminished ability to interpret social cues or interactions

Changes in emotion and affect

Emotional dysfunction can be a common symptom associated with psychosis, although it can also be observed in conditions like bipolar disorder, certain personality disorders, and more. Emotional changes one may experience with psychosis include:

• Inability to feel pleasure
• Extreme euphoria or elation without cause
• Inability to express emotions
• Extreme, inappropriate displays of emotion 
• Feelings of isolation and hopelessness

Brief psychotic disorder

Psychotic symptoms

• Hallucinations: Hallucinations generally involve seeing, hearing, feeling, smelling, or tasting stimuli that aren’t there. Auditory hallucinations, in which one hears nonexistent voices, tend to be the most common.
• Delusions: These typically refer to untrue beliefs that don’t align with reality. An individual with delusions usually maintains the validity of their beliefs despite clear evidence to the contrary. For example, one may think they’re being stalked or are receiving transmissions from outside entities. Individuals may also have delusions that they’re an important religious or historical figure or that they have special powers.  
• Disordered thoughts and speech: A person with brief psychotic disorder may experience disorganized thought patterns that result in bizarre, incomprehensible speech.
• Disordered or catatonic behavior: Peculiar behavioral patterns in which one may appear agitated, move spontaneously, or seem to have no motor control can be categorized as disordered. Meanwhile, catatonia, typically characterized by an absence of movement and response to outside stimuli, can be another type of psychotic behavior.

People with brief psychotic disorder may also experience cognitive symptoms, such as impaired memory and problem-solving skills, as well as emotional symptoms, like diminished emotional expression and a limited ability to experience pleasure. 

In general, to receive a diagnosis of brief psychotic disorder, one must present one or more of these symptoms, and they must not be better explained by an unrelated psychological or medical condition or the effects of a substance. 

Brief psychotic disorder diagnostic criteria usually state that the duration of an episode must last for at least one day but less than one month, with a return to the previous level of function after the episode. Most other psychotic disorders must feature continuous signs of the disturbance for at least six months, with at least one month of core symptoms.

Brief psychotic disorder subtypes 

There are several subtypes of brief psychotic disorder.

• Brief psychotic disorder with obvious stressor (formerly referred to as brief reactive psychosis): This generally refers to the sudden onset of psychotic symptoms occurring shortly after a severely stressful or traumatic event. Examples can include the sudden death of a loved one, abuse, assault, an accident, or a natural disaster.
• Brief psychotic disorder without obvious stressor: Psychotic symptoms tend to be brief but without an apparent trigger.
• Brief psychotic disorder with postpartum onset (postpartum psychotic disorder): The onset of symptoms usually occurs within four weeks after giving birth. 

Other conditions associated with temporary psychosis

There are several examples of transient psychotic disorders and other conditions that may feature shorter-term psychosis symptoms.

Schizophreniform disorder

This can be described as a condition similar to schizophrenia, but with milder symptoms that don’t persist as long. 

Bipolar disorder

Characterized by alternating manic and depressive episodes, bipolar disorder can feature mood-congruent psychosis, in which the symptoms reflect one’s moods, or mood-incongruent psychosis, in which symptoms are mismatched with one’s mood. 

Psychotic depression

Also categorized as a mood disorder, psychotic depression or depression with psychotic features can be characterized by severe depression in which individuals experience depressive symptoms, plus core psychotic symptoms like hallucinations and delusions.

Substance use disorders

Substance-induced psychosis can be common in individuals with a predisposition for psychotic symptoms, and it can also occur in individuals who do not have this predisposition. Cannabis, psychedelics, and amphetamines may be associated with substance-induced psychotic episodes. 

Medical conditions

Certain medical conditions may trigger psychotic episodes. For example, roughly up to half of patients with Alzheimer's disease (a type of dementia) may experience psychotic symptoms. Other medical conditions associated with an increased risk of psychosis include multiple sclerosis, head trauma, brain tumors, and certain infections.

Treatment and management for psychotic disorders 

Psychosis and psychotic disorders can often be managed with appropriate interventions. Treatments are typically comprehensive and involve a combination of methods. 

• Medication: Antipsychotics are normally the first line of treatment for psychosis, but doctors or psychiatrists may also prescribe mood stabilizers or antidepressants to manage secondary symptoms.
• Therapy: Cognitive behavioral therapy (CBT) tends to be the most common form of psychotherapy for psychosis. In CBT, individuals typically learn to identify and cope with triggers by adjusting unhelpful thought patterns.
• Support from friends and family: Family therapy is often recommended to teach family members communication and conflict resolution skills that may allow them to better support their loved one. Friends and family may benefit from psychoeducation about psychosis to cultivate empathy and understanding.
• Psychosocial intervention: Group therapy programs can help individuals with psychosis understand that they aren’t alone and that recovery is possible. In group therapy, peers often dicuss their experiences and support each other. 

Recovering from temporary psychosis?

Connect with a licensed therapist online

Seeking support during recovery from temporary psychosis or brief psychotic disorder

Psychotherapy can be a cornerstone of treatment. However, it isn’t always easy for individuals who have experienced psychosis to get the help they deserve. Difficulty finding care, scheduling issues, and affordability tend to be among the most commonly cited concerns, along with an aversion to interacting with others, such as staff or other patients in a traditional office environment.

Benefits of online therapy for managing psychotic symptoms

Online therapy can remove many of these obstacles, providing an effective alternative solution for individuals who have experienced psychosis. While in-person care may be warranted during periods of acute psychosis, online therapy may be appropriate for individuals in the recovery phase.

Effectiveness of online therapy for brief psychotic disorder and other psychotic disorders

Virtual treatment typically allows individuals to speak with their therapists from the comfort of their own homes on a convenient schedule. Because they can eliminate geographical barriers, online therapy platforms can make it easier to connect with a broader selection of mental health professionals, allowing individuals to choose a therapist with whom they feel comfortable.