Brief psychotic disorder is in the group of mental illnesses called the schizophrenia spectrum and other psychotic disorders.

• Symptoms of brief psychotic disorder can include hallucinations or delusions, and they last no longer than a month.
• The specific causes for brief psychotic disorder are usually not known, but it is thought to be due to a mix of inherited, biological, environmental, and psychological risk factors.
• Mental-health-care professionals perform a mental-health interview and examination to assess for the presence of brief psychotic disorder and rule out medical or other mental-health problems.
• Medications tend to be the mainstay of treating the symptoms of brief psychotic disorder, but cognitive behavioral psychotherapy can also help in recovery.
• Most people with brief psychotic disorder only have one episode, but some will eventually develop a more chronic mental illness.
• The prognosis of brief psychotic disorder is usually better than for other psychotic disorders.
• Cognitive behavioral therapy for the people with a number of risk factors for developing psychosis has been found to help prevent brief psychotic disorder.

What is a brief psychotic disorder?

Brief psychotic disorder is one of a number of mental illnesses that are referred to as schizophrenia spectrum and other psychotic disorders. Characteristics of this disorder may include hallucinations or delusions that last no more than one month. Studies show that a true brief psychotic episode that does not progress to another mental illness occurs in anywhere from one to four per 100,000 people, more commonly in women than in men. This illness usually develops in people 30-50 years of age, and an episode tends to last an average of 17 days. This differs somewhat from people who suffer from any first-time psychotic episode, which occurs in about 100,000 teens and young adults in the United States every year, has a peak onset between the ages of 15-25 years, and more commonly affects males versus females.

In addition to the more commonly known mental disorders like schizophrenia, other mental disorders in the schizophrenia spectrum and other psychotic disorders group includes schizotypal personality disorder, delusional disorder, schizophreniform disorder, schizoaffective disorder, catatonia, substance/medication-induced psychotic disorder, psychosis due to a medical condition, other specified schizophrenia spectrum and other psychotic disorder, as well as unspecified schizophrenia spectrum, and other psychotic disorders. Besides catatonia, other catatonia-related disorders include catatonic disorder due to another medical condition, as well as unspecified catatonia.

What are causes and risk factors for brief psychotic disorder?

Except for those psychotic disorders that result from the use of a substance or a medical condition, specific causes for most psychotic disorders are not known. However, the interplay of genetic (familial), biological, environmental, and psychological factors is thought to be involved. We do not yet understand all of the causes and other issues involved, but current research is making steady progress toward elucidating and defining causes of brief psychotic disorder and other psychotic disorders.

In biological models of psychotic disorders, genetic predisposition, infectious agents, toxins, allergies, and disturbances in metabolism have all been researched. Psychotic disorders like brief psychotic disorder are known to run in families. For example, people who have a close family member who has suffered from an episode of brief psychosis are more likely to develop the disorder than people with no such family history. Toxins like marijuana increase the risk of developing psychosis. Some medications are thought to be associated with developing, while not directly triggering, this illness in some people. Studies have not seemed to find ethnic differences in developing brief psychotic disorder.

The current concept is that multiple genes are involved in the development of psychosis and that risk factors such as prenatal (intrauterine), perinatal (around the time of birth), and nonspecific stressors are involved in creating a disposition or vulnerability to develop the illness. Neurotransmitters (chemicals allowing the communication among nerve cells) have also been implicated in the development of psychotic disorders like brief psychotic disorder. The list of neurotransmitters under scrutiny is long, but special attention has been given to dopamine, serotonin, and glutamate.

One form of brief psychotic disorder referred to as brief reactive psychosis has been found to be triggered by very stressful experiences, like placement in solitary confinement. People who have a low income, are unemployed, or are living alone are at higher risk for developing brief psychotic disorder than those who do not have these experiences.

Signs and symptoms of brief psychotic disorder can include the following:

• Delusions (beliefs that have no basis in reality)
• Hallucinations (for example, hearing voices or other noises not based in reality; seeing or otherwise perceiving things not actually present in any way)
• Disorganized speech (frequently off topic or nonsensical)
• Severely disorganized or catatonic behavior

Except for those psychotic disorders that result from the use of a substance or a medical condition, specific causes for most psychotic disorders are not known. However, the interplay of genetic (familial), biological, environmental, and psychological factors is thought to be involved. We do not yet understand all of the causes and other issues involved, but current research is making steady progress toward elucidating and defining causes of brief psychotic disorder and other psychotic disorders.

In biological models of psychotic disorders, genetic predisposition, infectious agents, toxins, allergies, differences in brain structure, and disturbances in metabolism have all been researched. Psychotic disorders like brief psychotic disorder are known to run in families. For example, people who have a close family member who has suffered from an episode of brief psychosis are more likely to develop the disorder than people with no such family history. Toxins like marijuana increase the risk of developing psychosis. Some medications are thought to be associated with developing, while not directly triggering, this illness in some people. Studies have not seemed to find ethnic differences in developing brief psychotic disorder.

Given the brief duration of brief psychotic disorder, medications tend to be an important part of addressing many of its symptoms. The first antipsychotic medication used for the treatment of schizophrenia was chlorpromazine (Thorazine). That was soon followed by medications like haloperidol (Haldol), fluphenazine (Prolixin), thiothixene (Navane), trifluoperazine (Stelazine), perphenazine (Trilafon), and thioridazine (Mellaril), which are now known as "neuroleptics" because, while they tend to be effective in treating positive symptoms of psychosis (for example, paranoia or other delusions, hallucinations), many of the side effects they can cause affect the neurologic (nervous) system. Examples of such side effects are muscle stiffness or rigidity, jitteriness, tremors, and muscle twitches. These older medications are thought to be not as effective against so-called negative symptoms like catatonia.

Since 1989, a new class of antipsychotics called atypical antipsychotics has been used. This group of medications tends to cause very few of the neurological side effects of the traditional antipsychotics. Clozapine (Clozaril) is the first atypical antipsychotic. It is not associated with neuroleptic side effects, but it can cause other problems, like a significant decrease in the number of white blood cells. Therefore, the blood needs to be monitored every week during the first six months of treatment and then every two weeks to find this side effect early if it occurs. Other atypical antipsychotics include risperidone (Risperdal), olanzapine (Zyprexa), quetiapine (Seroquel), ziprasidone (Geodon), aripiprazole (Abilify), paliperidone (Invega), asenapine (Saphris), iloperidone (Fanapt), and lurasidone (Latuda).

Since people with brief psychotic disorder are at increased risk of also having depression, medications that address that symptom can be an important part of treatment. Serotonergic medications like fluoxetine (Prozac), sertraline (Zoloft), paroxetine (Paxil), citalopram (Celexa), and escitalopram (Lexapro) are often prescribed because of their effectiveness and infrequent occurrence of side effects. Other antidepressant medications used to treat the depression that can be associated with brief psychotic disorder include venlafaxine (Effexor), duloxetine (Cymbalta), desvenlafaxine (Pristiq), and bupropion (Wellbutrin).

Cognitive behavioral psychotherapy (CBT) has been found to be helpful in helping the brief psychotic disorder sufferer manage some of the symptoms of this illness. CBT is a form of psychotherapy that focuses on helping the person understand and ultimately better manage how their thoughts and behaviors affect each other.

The current concept is that multiple genes are involved in the development of psychosis and that risk factors such as prenatal (intrauterine), perinatal (around the time of birth), and nonspecific stressors are involved in creating a disposition or vulnerability to develop the illness. Neurotransmitters (chemicals allowing the communication among nerve cells) have also been implicated in the development of psychotic disorders like brief psychotic disorder. The list of neurotransmitters under scrutiny is long, but special attention has been given to dopamine, serotonin, and glutamate.

One form of brief psychotic disorder referred to as brief reactive psychosis has been found to be triggered by very stressful experiences, like placement in solitary confinement. People who have a low income, are unemployed, or are living alone are at higher risk for developing brief psychotic disorder than those who do not have these experiences.