Brief Psychotic Disorder: What Does It Mean?
Different from other psychotic disorders, Brief Psychotic Disorder is characterized by its limited duration, and periods of confusion, delusions, and hallucinations – this disorder is most often seen when patients are in their 20s and 30s, but can occur at any age. This uncommon psychiatric condition is categorized by sudden, yet temporary, periods of psychotic behavior. These periods of psychotic behavior are known as psychotic breaks and may show themselves in many ways, including hearing ringing or voices, seeing flashes of light, or smelling or tasting things that other people cannot. Despite research studies involving over 11,000 patients who have suffered from some form of psychosis, little is known about the progression of psychosis.
What is a Psychotic Break?
A psychotic break is when someone experiences a short-term period of psychotic symptoms and may present itself in a number of ways, including crying, hallucinations, insomnia, irritability, or delusions. Symptoms vary greatly in patients and can be minor or quite severe. Many factors can contribute to a psychotic break, including traumatic events such as the death of a loved one.
Stats: How Many Suffer from this Disorder?
About one percent of the population experiences brief psychotic episodes, and impact men and women equally. Psychotic disorders are usually found in patients in their late teens to early 30s but can show themselves at any age. Many mental health professionals agree that people who have a family member with a history of a psychotic disorder are more likely to develop it than those with no family history.
What Causes Brief Psychotic Disorder?
Although the cause of Brief Psychotic Disorder is unknown, it is widely accepted that traumatic events such as the death of a loved one, surviving a natural disaster, or being physically or sexually assaulted can trigger brief psychotic episodes. Brief Psychotic Disorder tends to run in families; and biologic, environmental, genetic, and neurological factors can play a role as well. Periods of acute psychotic symptoms (psychotic breaks) can present themselves differently from person to person, and the onset of Brief Psychotic Disorder is often sudden. Despite traumatic events often triggering Brief Psychotic Disorder, the reasoning behind the frequency patients experience this disorder is still unknown – although family history can play a role in the prevalence of Brief Psychotic Disorder in family members, its onset can occur at any age. In addition to traumatic events, some women experience Brief Psychotic Disorder following childbirth – approximately 1 in 10,000 women experience a psychotic break following birth. Medical conditions may also trigger this disorder, although the exact cause of this triggering is unknown. Patients can experience Brief Psychotic Disorder while also suffering from specific forms of depression, HIV and AIDS, Alzheimer’s, Parkinson’s, lupus, and brain tumors.
Signs and Symptoms of Brief Psychotic Disorder
Symptoms of this psychotic disorder may seem similar to those present in schizophrenia, such as hallucinations, sudden and severe mood changes, sleep problems, and social and professional disinhibitions. Even though these characteristics may seem similar to schizophrenia, the symptoms are not as long-lived. Symptoms of Brief Psychotic Disorder last more than a day, but not more than a month – and careful diagnosis is required in order to separate Brief Psychotic Disorder-like symptoms from religious and cultural beliefs. Overall, there are three forms of Brief Psychotic Disorder – caused by a stressor (such as the death of a loved one,) without a stressor (or with no obvious stressor,) and postpartum.
Testing: What are the Diagnostic Criteria Per the DSM 5?
The DSM 5, the tool used by mental health professionals to classify mental disorders, classifies Brief Psychotic Disorder as “a thought disorder in which a person will experience short-term, gross deficits in reality testing, manifested with at least one of the following symptoms:
- Delusions- strange beliefs and ideas which are resistant to rational/logical dispute or contradiction from others.
- Hallucinations- auditory, or visual.
- Disorganized Speech- incoherence, or irrational content.
- Disorganized or Catatonic behavior- repetitive, senseless movements, or adopting a pose which may be maintained for hours. The individual may be resistant to efforts to move them into a different posture, or will assume a new posture they are placed in
Five specifiers can be used to describe the disorder further:
- With marked stressors- the psychotic episode appears following an acute stressor, or series of stressors, which would overtax the coping skills of most individuals.
- Without marked stressors- there is no apparent stressor preceding the psychotic episode.
- Post-partum- this disorder can appear during pregnancy or within one month following childbirth.
- With catatonia.
- Severity – The clinician can rate the severity of the psychotic episode during the last seven days using a five-point scale- Zero (Absent) to Four (Present and severe)
Brief Psychotic Disorder and Other Conditions
Brief Psychotic Disorder vs. Schizophrenia
The symptoms of Brief Psychotic Disorder are, well, brief, and can last from more than a day to less than one month before it can be classified as another disorder. Often, the symptoms of Brief Psychotic Disorder are much less severe than schizophrenia and schizoaffective disorder. Even though the severity can range from barely noticeable to severe, some of the symptoms, such as auditory and visual hallucinations are similar to schizophrenia and schizoaffective disorder.
Brief Psychotic Disorder is similar to other disorders where periods of brief psychosis may be present, such as bipolar disorder and delusional disorder, where periods of psychotc features like delusions and even auditory hallucinations are common.
Brief Psychotic Disorder in Adults/Children
Although this psychotic disorder tends to impact those in their late teens to early 30s, the onset of brief periods of psychosis can happen at any age and can be caused by stressors such as assault, death, or natural disasters. Brief Psychotic Disorder may be present in children during the aftermath of these traumatic events. Brief Psychotic Disorder may also be present in older patients who have received life-changing news such as a cancer diagnosis, although medical conditions may complicate the diagnosis of a psychotic disorder.
Example Case of Brief Psychotic Disorder
A 25-year-old man, let’s call him Michael, received a phone call while at work. His fiancée was in a car accident and tragically died on the way to the hospital. Upon hearing this news, Michael presented with irritability and social and professional disinhibitions. Later in the evening, his condition worsened, and he presented catatonic-like symptoms. His symptoms only lasted for a week, however. The diagnosis of Brief Psychotic Disorder makes sense in this scenario and is most likely the stressor-induced variety because of the life-changing news of his fiancée’s death. His symptoms are also consistent with the DSM 5 criteria, such as catatonic behavior and social and professional disinhibitions.
How to Deal/Coping with Brief Psychotic Disorder
Risk factors such as family history or going through a traumatic experience can raise concerns about the likelihood of Brief Psychotic Disorder. Auditory or visual hallucinations, catatonic behavior, or disorganized speech can also be warning signs. Living with Brief Psychotic Disorder can be difficult, but therapy and medication can help manage the symptoms of this psychotic disorder. If you are living with or know someone who suffers from Brief Psychotic Disorder, learn about the disorder and offer your support – as with all mental illnesses, having a support system can significantly improve your loved one’s state of mind.
Look out for These Complications/Risk Factors
Family history can play a role in the potential diagnosis of Brief Psychotic Disorder, along with experiencing traumatic events such as a natural disaster or physical or sexual assault. Along with these risk factors, other mental illnesses such as bipolar disorder may trigger psychotic breaks or periods of psychosis.
Brief Psychotic Disorder Treatment
Because the onset of Brief Psychotic Disorder is usually sudden and the side effects only last for one day to one month, the treatment of this disorder varies greatly. Initially, a diagnosis from a mental health professional is required to prescribe an antipsychotic medication, but patients may choose to seek therapy regardless of a medical diagnosis. Because Brief Psychotic Disorder has side effects that are not long-term, the therapy patients receive may focus more on the underlying cause of the psychotic episode as opposed to managing side effects, which can be the focus of therapy for depression, anxiety, and other mental illnesses. The psychological perspective of the therapist will determine the type of therapy a patient receives – the cognitive-behavioral perspective, for example, focuses on the reasoning behind behaviors and reaction to events. The Freudian perspective focuses on the roles of the conscious and subconscious.
Possible Medications for Brief Psychotic Disorder
Many medications are used in the treatment of Brief Psychotic Disorder, but observation is required to balance the side effects of the disorder with the side effects of the medication. Possible medications include:
- aripiprazole (Abilify)
- clozapine (Clozaril)
- risperidone (Risperdal)
- olanzapine (Zyprexa)
- quetiapine (Seroquel)
- ziprasidone (Geodon)
- paliperidone (Invega)
- asenapine (Saphris)
- iloperidone (Fanapt)
- urasidone (Latuda)
Home Remedies to Help Brief Psychotic Disorder
Aside from therapy and medication, many patients use home-based remedies to cope with symptoms of psychosis. Meditation may not help curb side effects such as irritability or delusions but can help sort out problems such as the traumatic event that may have triggered the psychosis. Brief Psychotic Disorder only lasts a short time in terms of symptoms, but the implications of the disorder may be long-term, and mindfulness may help patients curb future psychotic episodes. In addition to meditation, patients can also discuss their psychotic episode with friends and family members, so loved ones can be on the same page when it comes to living with Brief Psychotic Disorder.
Living with Brief Psychotic Disorder
When dealing with Brief Psychotic Disorder, the side effects may range from barely noticeable to debilitating, so naturally, living with Brief Psychotic Disorder varies as well. Although some patients only experience one episode of psychosis, some patients may experience recurring episodes. Medication, therapy, and home-based remedies may help manage side effects and recurring episodes.
Insurance Coverage for Brief Psychotic Disorder
Discussing potential insurance coverage for Brief Psychotic Disorder will help patients decide which type of treatment they wish to undergo. Insurance coverage for mental health can vary greatly depending on coverage and policy, with some patients paying next to nothing for medications and therapy, and others paying near full-price.
How to Find a Therapist
What Should I be Looking for in an LMHP?
When looking for a licensed mental health professional, be sure to look at their areas of expertise. Does he/she specialize in psychotic disorders such as Brief Psychotic Disorder? When contacting mental health professionals, be sure to ask about the psychological perspective they adhere to. What type of therapy is offered? How does therapy couple with other treatment types such as medication?
Questions to Ask a Potential Therapist
Ask your potential mental health professional if they have treated patients with Brief Psychotic Disorder before. Also, be sure to ask if they lean towards therapy, medication, or a combination of both. Understanding what kind of treatment a mental health professional provides before setting up an appointment can save both parties involved headaches.
Brief Psychotic Disorder Resources and Support Helpline
Resources for Brief Psychotic Disorder include NAMI, the National Alliance on Mental Illness, your friends and family members, and mental health professionals. NAMI also offers a helpline, to discuss treatment options and symptoms. Call 1-800-950-NAMI Monday through Friday, 10 a.m.– 6 p.m. ET and a mental health worker will discuss Brief Psychotic Disorder with you.