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Brief psychotic disorder

Brief reactive psychosis; Psychosis - brief psychotic disorder

Brief psychotic disorder is a sudden, short-term display of psychotic behavior, such as hallucinations or delusions, which occurs with a stressful event.

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Causes

Brief psychotic disorder is triggered by extreme stress, such as a traumatic accident or loss of a loved one. It is followed by a return to the previous level of function. The person may or may not be aware of the strange behavior.

This condition most often affects people in their 20s, 30s, and 40s. Those who have personality disorders are at high risk of having a brief reactive psychosis.

Symptoms

Symptoms of brief psychotic disorder may include the following:

• Behavior that is odd or out of character
• False ideas about what is taking place (delusions)
• Hearing or seeing things that aren't real (hallucinations)
• Strange speech or language

The symptoms are not due to alcohol or other illegal drug use, and they last longer than a day, but less than a month.

Exams and Tests

A psychiatric evaluation can confirm the diagnosis. A physical exam and laboratory testing can rule out medical illness as the cause of the symptoms.

Treatment

By definition, psychotic symptoms go away on their own in less than 1 month. In some cases, brief psychotic disorder can be the beginning of a more chronic psychotic condition, such as schizophrenia or schizoaffective disorder. Antipsychotic medicines can help decrease or stop the psychotic symptoms.

Talk therapy may also help you cope with the emotional stress that triggered the problem.

Outlook (Prognosis)

Most people with this disorder have a good outcome. Repeat episodes may occur in response to stress.

Possible Complications

As with all psychotic illnesses, this condition can severely disrupt your life and possibly lead to violence and suicide.

When to Contact a Medical Professional

Call for an appointment with a mental health professional if you have symptoms of this disorder.

If you or someone you know is thinking about suicide, call or text 988 or chat 988lifeline.org. You can also call 1-800-273-8255 (1-800-273-TALK). The 988 Suicide and Crisis Lifeline provides free and confidential support 24/7, anytime day or night.

You can also call 911 or the local emergency number or go to the hospital emergency room. DO NOT delay.

If someone you know has attempted suicide, call 911 or the local emergency number right away. DO NOT leave the person alone, even after you have called for help.

References

American Psychiatric Association website. Schizophrenia spectrum and other psychotic disorders. Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Text Revision (DSM-5-TR), Washington, DC: American Psychiatric Association Publishing; 2022.

Lim C, Paudel S, Holt DJ, Freudenreich O. Psychosis and schizophrenia. In: Stern TA, Wilens TE, Fava M, eds. Massachusetts General Hospital Comprehensive Clinical Psychiatry. 3rd ed. Philadelphia, PA: Elsevier; 2025:chap 27.

Lyness JM, Lee HB. Psychiatric disorders in medical practice. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 362.

Review Date: 5/4/2024  

Reviewed By: Fred K. Berger, MD, addiction and forensic psychiatrist, Scripps Memorial Hospital, La Jolla, CA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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