Brief Psychotic Disorder

While you only have to present with one symptom to be diagnosed with brief psychotic disorder, each of the symptoms is considered high-risk. These symptoms can include the following: 

• Delusions (beliefs that are demonstrably untrue but implicitly believed by the individual)
• Hallucinations that may include olfactory (smell), visual (sight), auditory (hearing), tactile (touch), or taste 
• Disorganized thought process or speech
• Disorganized behavior
• Catatonia (disengagement from stimuli, limited speech, and body movement, minimal to no interaction with their environment)
• Memory problems and struggling to make decisions
• Changes in habits and variations in energy level or weight

To qualify for a diagnosis of brief psychotic disorder, these symptoms must be present for between one day and one month and can’t be better explained by a diagnosis of schizophrenia, bipolar disorder⁴ with psychotic symptoms, or schizoaffective disorder. The disturbance in behavior may not be the result of a drug, prescribed medication, or a medical condition such as syphilis or sarcoidosis.

There is no clear, known cause for brief psychotic disorder. However, research suggests that there may be some genetic, neurological, or environmental factors involved. Those who have a personality disorder may be more likely to have a brief psychotic event. However, with a personality disorder, the symptoms may be transient (lasting less than one day). The main inciting event for brief psychotic disorder is a significant stressor or traumatic event, although there are three categories this disorder may fall under, including the following. 

Brief psychotic disorder with marked stressor 

Brief psychotic disorder with a marked stressor (also known as brief reactive psychosis) is a type of condition that presents in reaction to an extremely stressful situation or traumatic event. For example, war, natural disasters, a violent assault, or the death of a loved one may cause brief reactive psychosis. However, in some cultures, sensing the spirit of a loved one may be considered normal and may not be accompanied by pathological consequences. 

Brief psychotic disorder without a marked stressor

In this type of brief psychotic disorder, the person experiences the onset of psychotic symptoms without a traumatic event. In this case, it may not be that a traumatic event didn’t occur but that there isn’t a traceable stressor. The stressor could be general or less severe. 

Brief psychotic disorder with postpartum onset 

Brief psychotic disorder with postpartum onset is classified by the presence of symptoms in an individual who is within four weeks postpartum. Postpartum psychosis can be extreme and may require hospitalization or intensive mental health support. 

The first line of treatment for someone experiencing brief psychotic disorder is antipsychotic medications, especially second-generation antipsychotics. 

Medications

Oral formulations of medications may be preferred in the treatment of brief psychotic disorder, although intramuscular formulations may be used in emergency settings. 

Second-generation antipsychotic medications include:

• Paliperidone
• Quetiapine
• Risperidone
• Olanzapine (most commonly used in postpartum cases)

First-generation antipsychotics may also be used, but less commonly due to the possibility of more serious side effects like tardive dyskinesia, cogwheel rigidity, and acute dystonia. First-generation medications include:

• Fluphenazine
• Trifluoperazine
• Haloperidol
• Chlorpromazine
• Thioridazine

In patients who are acutely distressed or combative, medications in the benzodiazepine class may help clients manage symptoms. However, consult a medical doctor before starting, changing, or stopping medication for any condition. 

Other treatment options

In some cases of brief psychotic disorder, a person may be temporarily hospitalized to stabilize the condition, decrease risk, and start a treatment program. At this point, a social worker may work with the individual and their family to set up outpatient treatments or coordinate care with a mental health professional. 

The strongest treatment outcomes have been found with a strong interprofessional team approach. This approach includes working with health professionals like primary care providers, psychologists, psychiatrists, and mental health nurses. Adhering to the appropriate medication schedule can be essential, as well as working on the biosocial aspect by ensuring that the patient has sufficient emotional and physical support to decrease the disruptive effects of this disorder.

Even after a person with brief psychotic disorder has gone through their personalized treatment plan, continued therapy may be an effective way to address underlying challenges and offer tools for continued stress management. 

Online therapy platforms like BetterHelp offer opportunities to connect with therapists specializing in different areas. Fill out a questionnaire, and you can be matched with a therapist who meets your needs, who you can meet with over video conference, message, or phone. 

Below are other resources to offer more information on brief psychotic disorder and how it can affect both individuals and their family and friends:

• National Alliance On Mental Illness (NAMI)
• National Library of Medicine

For those with thoughts of suicide, contact 988 Suicide & Crisis Lifeline at 988.

Please also see our Get Help Now page for more immediate resources.

A recent systematic review and meta-analysis suggests that those with short-lived psychotic episodes are at a high risk of recurrence, especially in association with schizophrenia spectrum disorders. In addition, no consistent predictive factors have been found for brief psychotic disorder.  

A recent study into treatments for first time psychosis found that there needs to be a society-wide, universal, and globally-adopted model to offer pre-emptive interventions for individuals that are high-risk for recurrence, to provide the most effective treatment and reduce risk for further psychotic episodes. 

A study published in 2018 found that cognitive behavioral therapy (CBT) significantly improved symptoms of psychosis. Those who experienced symptoms of psychosis as a result of a schizophrenia diagnosis reported that CBT was valuable when used in conjunction with their antipsychotic medication but further reported that they found access to this type of therapy limited.

30% to 50% of individuals with brief psychotic disorder have no further psychotic episodes after symptoms go away

A Medscape overview of brief psychotic disorder found that 30% to 50% of individuals with brief psychotic disorder no longer experience episodes after their first episode symptoms disappear. Treatment for brief psychotic disorder is often brief, and remission rates are high.¹

¹Medscape

More statistics on brief psychotic disorder: 

• Data derived from the World Health Organization (WHO) found that brief psychotic disorder was more common in developing countries, with the population of these countries experiencing the condition at ten times the rate of the population in developed countries. 
• Research suggests that brief psychotic disorder is more common in women and those with existing personality disorders. 
• Brief psychotic disorder is found to be more frequent in populations that experience high stress or trauma, such as refugees, immigrants, or those who’ve experienced natural disasters.