What Is Brief Psychotic Disorder?

Brief psychotic disorder is the sudden onset of psychosis in which the symptoms last for more than 24 hours but less than 1 month. This period is followed by a complete remission but with the potential for future relapses.

Brief psychotic disorder may be further categorized according to whether or not it was triggered by marked stressors.

It may be categorized as the following:

• Brief psychotic disorder with marked stressors: Also called “brief reactive psychosis,” this describes the occurrence of psychotic symptoms in response to a traumatic event.
• Brief psychotic disorder without marked stressors: This refers to the onset of psychotic symptoms without a traumatic event.
• Brief psychotic disorder with postpartum onset: This refers to the onset of psychotic symptoms within 4 weeks of childbirth.

A diagnosis of brief psychotic disorder is often given after the episode is over because it’s difficult to distinguish it from other psychotic disorders, such as schizophrenia or schizophreniform disorder, when it’s still happening.

Brief psychotic disorder is much less common than other psychotic disorders. A Finnish population study from 2007 found the prevalence of brief psychotic disorder to be 0.05%. Another study in rural Ireland found that, among 196 people having their first bout of psychosis, only 10 had brief psychotic disorder.

Brief psychotic disorder is a severe but temporary condition featuring the onset of one or more of the following symptoms:

• delusions (persistent false beliefs)
• hallucinations (hearing or seeing things that aren’t there)
• disorganized speech (odd or inconsistent speech patterns)

Disorganized (odd) or catatonic behaviors may also be present.

These symptoms last at least 24 hours but less than 30 days. A person with brief psychotic disorder will return to typical functioning once the episode is over, usually in response to antipsychotic medication.

The primary difference between brief psychotic disorder, schizophreniform disorder, and schizophrenia is the duration of psychotic symptoms:

• Brief psychotic disorder: 24 hours to 30 days
• Schizophreniform disorder: 1–6 months
• Schizophrenia: chronic (long-term) mental health condition

It’s important to note that a person with brief psychotic disorder may go on to receive a diagnosis of schizophrenia or other psychotic disorder.

An analysis found that after 4.5 years, about 56% of people with brief psychotic episodes kept their original diagnosis, whereas 44% shifted to other diagnoses, with schizophrenia being the most frequent (21%).

Research suggests that you may be at greater risk for brief psychotic disorder if you:

• are experiencing high stress or trauma
• are female
• have a personality or mood disorder (this may be genetic or related to poorer coping skills)
• are an immigrant or refugee
• live in a developing country (10 times more common)

Brief psychotic disorder may be triggered by the following:

• pregnancy or childbirth
• death of a loved one
• environmental disaster
• recent immigration
• war

Brief psychotic disorder can also occur without a significant stressor. However, it’s important to note that it can’t be caused by medication, substance use, or a medical condition, as these would be completely different diagnoses.

Similar to schizophrenia and other mental disorders, it’s likely that there’s a genetic, neurological, or environmental component to the condition.

The first-line treatment for brief psychotic disorder includes atypical antipsychotic medications. In some cases, typical antipsychotics may be used. Benzodiazepines may also be helpful if you’re feeling agitated.

If you present to the emergency room with symptoms of brief psychotic disorder, the doctor would first need to determine whether you should be hospitalized or if you can be treated via outpatient care.

According to research, this decision is based on several factors:

• your symptoms
• family or friend support
• socioeconomic stability
• presence of suicidal or homicidal thoughts

There’s no lab or psychological testing used to detect brief psychotic disorder. You may receive certain tests and imaging to determine a catalyst for the behaviors or to rule out other conditions. These tests might include:

• pregnancy test
• electrolyte level test
• glucose level test
• thyroid function test
• liver function test
• urinalysis (to exclude potential drug intoxication or withdrawal)
• electrocardiogram (to check your heart)
• CT scan or MRI of the brain (to check for structural abnormalities causing symptoms)

It’s important to rule out the following psychosis-triggering disorders:

• psychosis from substance use or medication
• syphilis
• thyrotoxicosis (unusually high thyroid hormones)
• sarcoidosis (inflammation in the cells often triggered by bacteria, viruses, or chemicals)

The following disorders should also be ruled out over time:

• major depressive disorder with psychotic features
• bipolar disorder with psychotic features
• schizophrenia
• schizoaffective disorder
• schizophreniform disorder

Brief psychotic disorder is a type of psychosis that lasts for more than 24 hours but less than a month. Similar to schizophrenia, brief psychotic disorder may include delusions, hallucinations, or disorganized thinking.

This psychosis is followed by a complete remission, but future relapse is possible. It’s commonly triggered by outside stressors, but not always.

Brief psychotic disorder is more common among people who’ve experienced trauma. Additionally, women, people with personality disorders, those who’ve just given birth, and immigrants (who may experience high stress) may also be at higher risk.

If you or a loved one is experiencing any symptoms of psychosis, consider reaching out to a mental health professional to get a full evaluation and learn your treatment options.