Brief psychotic disorder (BPD) is a sudden onset of at least one psychotic symptom that lasts from one day to one month.1,2 Psychotic symptoms include severely disorganized or catatonic-type behavior, hallucinations, delusions, and incoherent speech or thought.1,2 Treatments for brief psychotic disorder include individual therapy, family or group therapy, and psychotropic medications.
What Is Brief Psychotic Disorder?
The American Psychological Association (APA) classifies BPD as a “thought disorder” that presents as an abrupt, abnormal appearance of psychosis. Individuals can have more than one experience of BPD, but to meet criteria, symptoms must last no longer than one month or be better explained by physical health issues, substance use/withdrawal, or other mental health diagnoses.1,2,3,4 Although there are outliers, BPD is most commonly seen in teenagers and young adults.2
What Is a Psychotic Break?
While individuals who experience brief psychotic disorder may be considered to have experienced a psychotic break, that’s not always the case. Psychotic breaks can be diagnosed in conjunction with a number of issues, including psychosis related to substance use or misuse, physical health issues, or in individuals who may later be diagnosed with schizophrenia or other psychotic disorders.2,5,6,7
Additionally, psychotic breaks may not be as abrupt as brief psychotic disorder. In some cases, individuals who experience a “break” may have worsening symptoms that don’t fall within the one month limitation of BPD.
Types of Brief Psychotic Disorder
Brief psychotic disorder is defined by the abrupt appearance of psychotic symptoms and the symptoms or environments in which an individual presents. Different types of BPD can influence how the individual is treated or monitored. Each presents with different levels of severity that professionals use to determine risk.4
Three types of brief psychotic disorder are:
- Brief reactive psychosis: This type is also referred to as a psychotic disorder with noted stressors.4 It can be seen following an event or a series of events/stressors that could overwhelm someone’s ability to cope
- Brief psychotic disorder without noted stressors: This type can be seen with no noted influence from a stressor or series of events that would overwhelm most people’s ability to cope4
- Brief psychotic disorder postpartum type: This type can be seen during an individual’s pregnancy or during the four weeks following delivery of a child4
Symptoms of Brief Psychotic Disorder
To be diagnosed with a brief psychotic disorder, individuals have to present with only one symptom. However, each symptom presents a high level of risk.4
Symptoms of brief psychotic disorder include:3,4
- Hallucinations (auditory, visual, tactile, olfactory, taste)
- Delusions (untrue beliefs that cannot be challenged, such as delusions of grandeur)
- Disorganized speech or thought process (difficulty staying on topic or difficulty speaking clearly)
- Disorganized behavior (difficulty staying engaged in conversation or behavior or difficulty engaging in clear or appropriate behavior)
- Catatonic behavior (not engaging in environment, highly reduced interaction or response, minimal to no speech, limited body movement)
What Causes Brief Psychotic Disorder?
Brief psychotic disorder has a number of potential contributors including stress or trauma or the existence of a personality or mood disorder.
Four potential causes of brief psychotic disorder include:
- Major stress or trauma. Although research is ongoing, this is a primary documented cause of BPD. There is evidence of increased presentation in individuals who have experienced natural disasters or in groups who may experience high stress, such as immigrants of some developing countries5,6
- Genetics5
- Childbirth6
- A previous diagnosis of personality disorder or mood disorder. Studies suggest this may be brought on by a struggle to manage symptoms or build effective coping skills5
Treatment for Brief Psychotic Disorder
Certain BPD treatments can help reduce symptoms, teach coping mechanisms, and aid in the individual’s recovery. These treatments include individual and family or group therapy, medication, and, in severe cases, brief hospitalization.
Therapy
Therapy can be an effective treatment tool for individuals who are experiencing or have a history of brief psychotic periods. Types of therapy for BPD include:
- Cognitive behavioral therapy (CBT)
- Cognitive enhancement therapy (CET)
- Acceptance and commitment therapy (ACT)
- Family and group therapy
Each of these therapies can help in different areas by teaching reality testing, symptom insight and awareness, as well as increasing rational thought connection skills. They can also help the patient accept emotions and thoughts and let them pass without a major increase in risk.8 Family and group therapy, in particular, increase communication surrounding concerns and symptom awareness. These interventions also help individuals create a support system of people who empathize with their situation.8 Choosing Therapy’s online directory is a great resource for finding a therapist.
Medication
Medication is a more common, effective treatment for psychotic periods. While there is no medication made for brief psychotic disorder alone, a number of medications exist to treat short- or long-term psychosis. As such, they can help stabilize individuals experiencing BPD. For medication to be prescribed, whether in an emergency situation or long-term, it must be prescribed by a primary-care physician, psychiatrist, or nurse practitioner.5,8
Regarding psychosis, medication is primarily prescribed to help reduce symptoms, enhance one’s ability to distinguish reality from psychosis (i.e., reality testing), stabilize the individual’s mood, and reduce risk. In some cases, medication in the form of an injection or pill like lorazepam or haldol may also be used to calm the individual if they’re a risk to themselves or others.
Hospitalization & Outpatient
Although rarely discussed, an individual experiencing a psychotic episode, whether it is brief or related to their health, drug use, or so forth, may be hospitalized briefly to stabilize them, decrease their risk, and get treatment. If they are hospitalized, they will often receive medication and therapy. The hospital social worker will likely discuss outpatient treatment with them and their loved ones, depending on their support system.2
Whether an individual is hospitalized, community treatments can help stabilize patients with BPD, especially if they continue to have undiagnosed psychotic periods. Community-case management or coordinated care with a mental-health agency can help them receive assessment for their continued symptoms and potentially help them receive treatment, whether it is through therapy, medication, or other community resources. These types of treatment resources also help encourage people to stay on their medications, which is a major difficulty in psychosis-related disorders.8
Final Thoughts on Brief Psychotic Disorder
Brief psychotic disorder can be a scary and challenging condition, both for the individual who experiences it and their loved ones. Fortunately, options for help, support, and stabilization exist, especially in trauma-related situations. You are not alone on this journey. Whether it is you or a loved one who is struggling, check in with a therapist for help.
