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Brief Psychotic Disorder

by S. Charles Schulz, MD

Brief psychotic disorder consists of delusions, hallucinations, or other psychotic symptoms for at least 1 day but < 1 mo, with eventual return to normal premorbid functioning. It is typically caused by severe stress in susceptible people.

Brief psychotic disorder is uncommon. Preexisting personality disorders (eg, paranoid, histrionic, narcissistic, schizotypal, borderline) predispose to its development. A major stressor, such as loss of a loved one, may precipitate the disorder. The disorder causes at least one psychotic symptom:

  • Delusions

  • Hallucinations

  • Disorganized speech

  • Grossly disorganized or catatonic behavior

This disorder is not diagnosed if a psychotic mood disorder, a schizoaffective disorder, schizophrenia, a physical disorder, or an adverse drug effect (prescribed or illicit) better accounts for the symptoms.

Differentiating between brief psychotic disorder and schizophrenia in a patient without any prior psychotic symptoms is based on duration of symptoms; if the duration exceeds 1 mo, the patient no longer meets required diagnostic criteria for brief psychotic disorder.

Treatment is similar to that of an acute exacerbation of schizophrenia; supervision and short-term treatment with antipsychotics may be required. Relapse is common, but patients typically function well between episodes and have few or no symptoms.

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