Brief psychotic disorder (BPD) is a short-term disturbance that involves sudden onset of at least 1 positive psychotic symptom (e.g., delusions, hallucinations, disorganized speech, grossly disorganized or catatonic behavior).
Episode lasts for a short duration (1 to 30 days), with return to full premorbid level of functioning; can occur in the presence or absence of a major stressor.
Diagnosis can only be made if other drug-induced, medical, neurologic, or other psychiatric conditions can be excluded as causes.
Postpartum BPD is probable when the onset of psychotic symptoms occurs within 4 weeks after giving birth.
Treatment is with antipsychotic medication and follow-up care with a psychiatric specialist to monitor progress and reduce risk of recurrence.
Brief psychotic disorder (BPD) is a short-term disturbance that involves the sudden onset of at least 1 positive psychotic symptom. These symptoms include delusions, hallucinations, disorganized speech (e.g., frequent derailment or incoherence), or grossly disorganized or catatonic behavior, where at least 1 symptom must be delusions, hallucinations, or disorganized speech.
BPD can last between 1 and 30 days before the patient fully returns to the premorbid level of functioning.
To be diagnosed as BPD, the disturbance must not be substance induced and not be better accounted for by schizoaffective disorder, a mood disorder with psychotic features, schizophrenia, or a general medical condition (e.g., seizure disorder, syphilis, sarcoidosis, lung cancer, thyrotoxicosis, or head trauma). BPD is categorized as occurring with marked stressors, without marked stressors, or peripartum.
History and exam
Key diagnostic factors
- presence of risk factors
- at least 1 positive psychotic symptom lasting >1 day but <1 month
- symptoms not due to substance use
- symptoms not due to medical condition
Other diagnostic factors
- pregnant or within 4 weeks postpartum
- recent stress and trauma
- significant life stressor
- personality disorder
- family history of psychotic disorder
- pregnancy or 4 weeks postpartum
- previous psychiatric symptoms in women
- age 35 to 45 years
- single mother
1st investigations to order
- serum pregnancy test (females)
Investigations to consider
- syphilis serology
- urine toxicology
- CT scan brain
- MRI brain
able to accept or tolerate oral treatment
refusing or unable to tolerate oral medication
- Delusional disorder
- Major depressive disorder with psychotic features
- Optimizing pharmacologic treatment of psychotic disorders: the Expert Consensus Guideline Series
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