Brief Psychotic Disorder

Key Takeaways

• Brief psychotic disorder is a mental health condition that causes someone to experience delusions and hallucinations after a traumatic event.

• While this condition resolves within one month of its onset and individuals return to their prior level of functioning, brief psychotic disorder places someone at risk of future psychotic episodes. This risk is particularly high within three years of the initial episode.

• Psychoeducation, community reintegration, and social skills are essential to managing this condition. Oral atypical antipsychotics are considered most beneficial from a pharmacological standpoint.

Understanding brief psychotic disorder

This transient mental health condition develops as a result of a traumatic or stressful event and leads someone to experience psychotic symptoms, including delusions and hallucinations. Individuals with this condition may or may not be aware of their behavior.^[2] Brief psychotic disorder lasts between 24 hours and one month, and individuals return to their prior level of functioning once symptoms have resolved.^[3]

How common is it?

The short-term nature of brief psychotic disorder makes it difficult to pinpoint its exact prevalence. However, research shows this condition occurs in about 0.05% of the population.^[4]

Brief psychotic disorder symptoms

The two main symptoms of brief psychotic disorder are delusions and hallucinations. These present in the following ways:

• Engaging in odd, eccentric behavior that is either not appropriate for the situation or is out of character for the person.

• Bizarre language or speech that may or may not follow a pattern or cadence.

• Holding incorrect ideas about the world around them.

• Seeing, hearing, or feeling things that are not real.

To be classified as a brief psychotic disorder, the above symptoms must not be due to a medical condition or substance use.^[2][1][4]

What are brief limited intermittent psychotic symptoms?

When someone exhibits brief limited intermittent psychotic symptoms (BLIPS), their hallucinations and delusions occur for seven days or less. There is a strong likelihood that brief limited intermittent psychotic symptoms are attributed to other mental health concerns, though it may be difficult to make this judgment when they arise. ^[5]

Causes

The main cause of this condition is significant stress or trauma, such as the sudden loss of a loved one, a major accident, or extreme violence. Brief psychotic disorder with clear sources may also be referred to as brief reactive psychosis.^[1][2] This condition may also develop and resolve within four weeks of a woman giving birth.^[1]

Some individuals develop brief psychotic disorder in the absence of a stressor. In these cases, research suggests there may be genetic and environmental factors at play.

Can stress bring it on?

Yes, extreme stress can bring about brief psychotic disorder. When this occurs, the traumatic event must be considered very stressful for any individual of the same culture in a similar situation.^[1]

Risks and complications

Individuals with poor coping skills and fixed behaviors (with or without other mental health concerns) may be at an increased risk of developing brief psychotic disorder. The main complication associated with brief psychotic disorder is the temporary loss of function that an individual experiences.^[1] Having this condition places someone at an increased risk of additional brief psychotic episodes as well as more lasting conditions, such as affective disorders and other psychotic disorders.^[4]

Prevention

Psychotic disorders, especially when as brief as this, are difficult to prevent. However, lifestyle adjustments and protecting oneself from other medical conditions can help. Eating a balanced diet, managing weight, and minimizing stress are always recommended to stay mentally well.

In addition, individuals are advised to avoid traumatic brain injuries and infections, as these can increase someone’s risk of psychosis. In the event these health concerns do occur, early and complete treatment is advised to reduce the likelihood of neurological complications.^[6]

Individuals who have experienced brief psychotic disorder are at a particularly high risk of recurrence within the three years following the initial psychotic episode. Therefore, relapse prevention strategies and continued clinical monitoring are advised.^[5]

Diagnosing brief psychotic disorder

Mental health professionals typically begin with physical exams and laboratory testing to rule out medical conditions that may be the source of psychotic symptoms. Once this is done, mental health assessments are used to confirm the presence of a psychiatric condition.^[2]

Because of how rapid the onset and duration of brief psychotic disorder are, mental health professionals often make this diagnosis after symptoms have resolved. This allows providers to confirm hallucinations and delusions occurred within the one-month time frame.^[1][2]

Tests and assessments

There are no specific psychiatric tests used to diagnose brief psychotic disorder. Common medical tests used to help rule out any physical causes of psychosis include urinalysis, thyroid function tests, electrolyte panels, glucose levels, liver function tests, and electrocardiograms (ECG).^[6]

Treatment options

There are a variety of treatment options for brief psychotic disorder. Mental health providers make recommendations based on the severity of symptoms, the level of functional impairment someone experiences, and whether or not they pose a risk to themselves or others.

Medication

Oral medications are the first-line pharmacological treatment for psychotic symptoms. If someone seeks immediate care through an emergency department or similar setting, they may be given intramuscular medications instead. Second-generation (atypical) antipsychotics are the most common drug class for psychotic symptoms, but first-generation (typical) antipsychotics and benzodiazepines may be prescribed for some people. First-generation (typical) antipsychotics are often recommended due to their risk of extrapyramidal side effects. Benzodiazepines are particularly beneficial for individuals with aggression due to psychosis. ^[1]

Therapy

Psychotherapy for brief psychotic disorder focuses on educating individuals and their loved ones about the condition and how to manage it. Various modalities are also used to assist with community reintegration and socialization. Individuals must learn to manage comorbidities and develop coping skills to manage existing episodes and prevent relapse. ^[1]

Hospitalization and Residential Treatment

During the diagnostic process, providers should determine what the most appropriate level of care is for the individual. Outpatient hospital treatment may be acceptable for individuals who have social support to assist in the treatment process and adhere to medication and appointments.

Hospitalization or residential care may be necessary for individuals with this condition who engage in reckless behaviors, attempt to harm themselves, or are violent toward others.^[1] Hospitalization for any mental health concern focuses on safety and the stabilization of an individual’s mental health.

Self-care and management

If you are diagnosed with brief psychotic disorder, be sure to follow your provider’s recommendations to properly manage this condition. In addition, leading a healthy lifestyle and properly managing stress will lead to the best outcomes during the course of the condition and after symptoms have subsided.

Supporting someone with brief psychotic disorder

Loved ones must educate themselves on brief psychotic disorder to best help someone who has the condition. If you have a loved one with brief psychotic disorder, refrain from giving them advice or arguing with them. Delusions make it so that someone does not see the world in the same way as others do. Therefore, making them see your point of view will not be helpful and will only serve to agitate them. It’s best to remain non-judgmental, gently encourage your loved one to seek help (if they aren’t already), and ask how you can best support them.