Brief Psychotic Disorder

Brief Psychotic Disorder

Brief Psychotic Disorder

Brief psychotic disorder (BPD) is a mental health condition characterized by the presence of at least one short-term psychotic symptom — such as delusions, hallucinations, incoherent speech, or behavioral disturbances — which lasts from one day to one month in duration and which is often accompanied by significant distress. BPD is usually preceded by a significant stressor such as bereavement or childbirth.

It’s only a brief psychotic disorder if the person fully reverts to their previous level of functioning after the onset.

There are three types of BPD:

  1. BPD with Marked Stressor(s) — also known as brief reactive psychosis. The onset of psychotic symptoms occurs following a traumatic event that would be stressful for anyone in similar circumstances in the same culture.
  2. BPD without Marked Stressor(s) — is the onset of psychotic symptoms that occur in the absence of a traumatic event that would be stressful for anyone in similar circumstances in the same culture.
  3. BPD with Postpartum Onset — is defined as the onset of psychotic symptoms that occur within four weeks of childbirth.

Prevalence

The male to female ratio of BPD is 1:2, and the condition is more common in people with a personality disorder. The onset of symptoms of BPD is usually in the late 30s and early 40s, but it can appear in adolescence.

The rates of BPD are higher in the developing world than in the developed world, and it may account for 9% of cases of first-onset psychosis. The chance of relapse is high.

Symptoms of Brief Psychotic Disorder:

Some of the signs and symptoms that might appear quite normal in some cultures could be misdiagnosed in other cultures as being delusional in nature, such as seeing visions or hearing voices. Examples include:

  • Sudden (within 2 weeks) delusions, hallucinations, incoherent speech, very abnormal bodily movements, or catatonia
  • Changes last from one day to one month and then the person functions as before.
  • Emotional turmoil or overwhelming confusion
  • Rapid shifts from one effect to another
  • Severe impairment — judgment, cognitive
  • Suicidal behavior

Diagnosis of Brief Psychotic Disorder:

To make a diagnosis of BPD, other conditions with psychotic symptoms must be ruled out. Medical conditions such as diabetes or substance abuse must also be excluded.

The DSM-5 lists criteria for diagnosing brief psychotic disorder as follows:

  • Presence of one (or more) of the following symptoms. At least one of these must be (1), (2), or (3):

    1. Delusions
    2. Hallucinations
    3. Disorganized speech (e.g., frequent derailment or incoherence).
    4. Grossly disorganized or catatonic behavior.

    Note: Do not include a symptom if it is a culturally sanctioned response.

  • Duration of an episode of the disturbance is at least 1 day but less than 1 month, with
    eventual full return to premorbid level of functioning.
  • The disturbance is not better explained by major depressive or bipolar disorder with
    psychotic features or another psychotic disorder such as schizophrenia or catatonia,
    and is not attributable to the physiological effects.

The disorder is usually also rated in severity out of 5, but it doesn’t have to be.

Causes of Brief Psychotic Disorder:

The exact cause of BPD remains unknown; however, certain factors have been implicated.

  • Genetic – BPD is more common in people who have a family history of mood disorders.
  • Pre-existing personality disorders – can heighten the person’s predisposition to having brief psychotic disorder.
  • Biological – Low estrogen has been seen to cause BPD, which can happen before a menstrual period, after childbirth, or during menopause.

Treatment of Brief Psychotic Disorder:

Treatment for BPD includes medication and/or psychotherapy, with the main goal being to stop any self-harm or fatal consequences during the period of psychosis.


  • Admission – Hospitalization may be necessary if symptoms are severe and if the patient has thoughts of harming self and/or others or is exhibiting suicidal and/or homicidal behavior.
  • Medication – Medication can be associated with adverse effects such as weight gain and must be managed and monitored by a psychiatrist.

    • Antipsychotics – to reduce psychotic symptoms and agitation
    • Antianxiety meds – to reduce anxiety
    • Mood stabilizers – to stabilize mood changes
    • Sedatives – Benzodiazepines to reduce anxiety and enhance relaxation
  • Psychotherapy

    • Cognitive behavioral therapy – to examine triggers that cause a person to feel so overwhelmed and anxious that the mind goes into a psychotic state. It also teaches people to choose ways of processing stressful thoughts, and learning coping skills, that result in a more positive reaction. Long-term CBT can significantly reduce the chance of a repeated occurrence or of it predisposing a chronic psychotic disorder.
    • Compliance therapy – to educate on the importance of regular medication and to set up reminders for pill taking and scheduled doctor and therapy visits
    • Family interventions – to give an additional perspective on how the psychotic episodes are affecting the family unit and to strategize on what to do until it ends or should another one occur.
    • Video recorded self-observation – can help greatly in seeing how one’s brief psychosis affects others

People with this condition experience a complete resolution of symptoms and return to their previous level of functioning, although BPD can occur on more than one occasion with complete remission between episodes.

If you are experiencing suicidal thoughts, you can call the Suicide Prevention Hotline and talk for free at 1-800-SUICIDE (1-800-784-2433) or 1-800-273-TALK (1-800-273-8255). They can also provide you with information about low-cost clinics and therapists for your depression.

Symptoms of Brief Psychotic Disorder:

Some of the signs and symptoms that might appear quite normal in some cultures could be misdiagnosed in other cultures as being delusional in nature, such as seeing visions or hearing voices. Examples include:

  • Sudden (within 2 weeks) delusions, hallucinations, incoherent speech, very abnormal bodily movements, or catatonia
  • Changes last from one day to one month and then the person functions as before.
  • Emotional turmoil or overwhelming confusion
  • Rapid shifts from one effect to another
  • Severe impairment — judgment, cognitive
  • Suicidal behavior

Diagnosis of Brief Psychotic Disorder:

To make a diagnosis of BPD, other conditions with psychotic symptoms must be ruled out. Medical conditions such as diabetes or substance abuse must also be excluded.

The DSM-5 lists criteria for diagnosing brief psychotic disorder as follows:

  • Presence of one (or more) of the following symptoms. At least one of these must be (1), (2), or (3):

    1. Delusions
    2. Hallucinations
    3. Disorganized speech (e.g., frequent derailment or incoherence).
    4. Grossly disorganized or catatonic behavior.

    Note: Do not include a symptom if it is a culturally sanctioned response.

  • Duration of an episode of the disturbance is at least 1 day but less than 1 month, with
    eventual full return to premorbid level of functioning.
  • The disturbance is not better explained by major depressive or bipolar disorder with
    psychotic features or another psychotic disorder such as schizophrenia or catatonia,
    and is not attributable to the physiological effects.

The disorder is usually also rated in severity out of 5, but it doesn’t have to be.

Causes of Brief Psychotic Disorder:

The exact cause of BPD remains unknown; however, certain factors have been implicated.

  • Genetic – BPD is more common in people who have a family history of mood disorders.
  • Pre-existing personality disorders – can heighten the person’s predisposition to having brief psychotic disorder.
  • Biological – Low estrogen has been seen to cause BPD, which can happen before a menstrual period, after childbirth, or during menopause.

Treatment of Brief Psychotic Disorder:

Treatment for BPD includes medication and/or psychotherapy, with the main goal being to stop any self-harm or fatal consequences during the period of psychosis.


  • Admission – Hospitalization may be necessary if symptoms are severe and if the patient has thoughts of harming self and/or others or is exhibiting suicidal and/or homicidal behavior.
  • Medication – Medication can be associated with adverse effects such as weight gain and must be managed and monitored by a psychiatrist.

    • Antipsychotics – to reduce psychotic symptoms and agitation
    • Antianxiety meds – to reduce anxiety
    • Mood stabilizers – to stabilize mood changes
    • Sedatives – Benzodiazepines to reduce anxiety and enhance relaxation
  • Psychotherapy

    • Cognitive behavioral therapy – to examine triggers that cause a person to feel so overwhelmed and anxious that the mind goes into a psychotic state. It also teaches people to choose ways of processing stressful thoughts, and learning coping skills, that result in a more positive reaction. Long-term CBT can significantly reduce the chance of a repeated occurrence or of it predisposing a chronic psychotic disorder.
    • Compliance therapy – to educate on the importance of regular medication and to set up reminders for pill taking and scheduled doctor and therapy visits
    • Family interventions – to give an additional perspective on how the psychotic episodes are affecting the family unit and to strategize on what to do until it ends or should another one occur.
    • Video recorded self-observation – can help greatly in seeing how one’s brief psychosis affects others

People with this condition experience a complete resolution of symptoms and return to their previous level of functioning, although BPD can occur on more than one occasion with complete remission between episodes.

If you are experiencing suicidal thoughts, you can call the Suicide Prevention Hotline and talk for free at 1-800-SUICIDE (1-800-784-2433) or 1-800-273-TALK (1-800-273-8255). They can also provide you with information about low-cost clinics and therapists for your depression.

Sources DRUGS.com – Brief Psychotic Disorder | MEDICINE NET – Brief Psychotic Disorder | RESEARCH GATE – Psychotic Disorders and Menopause | NIH PUB MED – Clarifying the onset of brief psychotic disorder at childbirth | Nolen-Hoeksema, Susan (2014). Abnormal Psychology (6th ed.). New York, NY: McGraw-Hill Education. pp. 230–231.