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Brief Psychotic Disorder

ByMatcheri S. Keshavan, MD, Harvard Medical School
Reviewed ByMark Zimmerman, MD, South County Psychiatry
Reviewed/Revised Modified Jul 2025
v1029019
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Brief psychotic disorder consists of delusions, hallucinations, or other psychotic symptoms for ≥ 1 day and < 1 month, with eventual return to normal premorbid functioning. Treatment is with psychosocial support and, when necessary, antipsychotics.

Brief psychotic disorder is uncommon. Preexisting personality disorders (eg, paranoid, histrionic, narcissistic, schizotypal, borderline), as well as certain medical conditions (eg, systemic lupus erythematosus, steroid ingestion), predispose to its development. A major stressor, such as loss of a loved one, may precipitate the disorder.

Patients with the disorder manifest at least one psychotic symptom for ≥ 1 day and < 1 month:

  • Delusions

  • Hallucinations

  • Disorganized speech

  • Grossly disorganized or catatonic behavior

Brief psychotic disorder is not diagnosed if a psychotic mood disorder, a schizoaffective disorder, schizophrenia, a physical disorder, or an adverse drug effect (from therapeutic or illicit drug use) better accounts for the symptoms. If this condition occurs in the context of marked stress, it is called brief reactive psychosis (1).

Differentiating between brief psychotic disorder, schizophreniform disorder, and schizophrenia in a patient without any prior psychotic symptoms is based on duration of symptoms; if the duration exceeds 1 month, the patient no longer meets required diagnostic criteria for brief psychotic disorder.

Treatment of brief psychotic disorder is similar to treatment of an acute exacerbation of schizophrenia; supervision and short-term treatment with antipsychotics may be required.

Relapse is common, but patients typically function well between episodes and have few or no symptoms. There does appear to be increased risk, in those with brief psychotic disorder, of developing schizophrenia or another disorder on the schizophrenia spectrum (2).

References

  1. 1. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition Text Revision, DSM-5-TR (DSM-5-TR). American Psychiatric Association Publishing, Washington, DC, 2022, pp 109-112.

  2. 108-111.

  3. 2. Fusar-Poli P, Cappucciati M, Bonoldi I, et al. Prognosis of Brief Psychotic Episodes: A Meta-analysis. JAMA Psychiatry. 2016;73(3):211-220. doi:10.1001/jamapsychiatry.2015.2313.

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