Brief Psychotic Disorder

A Brief Psychotic Disorder is characterized by a rapid, brief manifestation of psychotic activity, such as hallucinations or delusions, in response to a stressful incident. According to the DSM-5, brief psychotic disorder (BPD) is the rapid start of psychotic activity that lasts less than one month, followed by full remission with the possibility of future relapses.  

Overview

Brief Psychotic Disorder (BPD) is one of the disorders on the schizophrenia spectrum and other classes of psychotic disorders. This condition may be characterized by hallucinations or delusions that resolve within one month of their onset. According to studies, a genuine short psychotic episode that is not linked to other mental illnesses happens in 1 to 4 people out of every 100,000 with women being at higher risk. 

This condition generally affects individuals between the ages of 30 and 50, and an episode lasts on average 17 days. This varies from those who suffer from a first-time psychotic episode, which strikes around 100,000 teenagers and young adults in the United States each year. The peak onset is between the ages of 15 and 25 and affects females more frequently than males.

Opioid-Use-Disorder-overview

Epidemiology of Brief Psychotic Disorder (BPD)

There is a lack of reliable data on the frequency of BPD because of its low prevalence and fluctuation which is dependent on the population under investigation. However, the condition is more common in populations known to be under stress, such as immigrants, refugees, earthquake victims, and so on.

A survey demonstrated that the prevalence of BPD was 0.05 percent. It has a higher incidence in underdeveloped nations versus developed ones.  According to the World Health Organization (WHO), the incidence of BPD in underdeveloped countries is 10 times higher than in affluent ones. BPD is also considered to be more prevalent among women and individuals who have a personality disorder.

Sign and symptoms of Brief Psychotic Disorder:

The following are some signs and symptoms of brief psychotic disorder:

  1. Delusions
  2. Hallucinations
  3. Incoherent speaking
  4. Extremely chaotic or catatonic behavior

Symptoms of BPD range from one day to one month, with full restoration to normal functioning after the psychotic episode is over. 

Prevalent types of Brief Psychotic Disorder (BPD)

Although the exact cause of short psychotic illness is unknown, it is thought to be triggered by a stressful incident or trauma. BPD may also have a genetic, neurological, or environmental component. If BPD exists, a particular trigger must be identified. 

  1. Brief reactive psychosis is a term used to describe a brief psychotic episode triggered by a significant stressor. It is the emergence of psychotic symptoms as a result of a traumatic incident that would be distressing for everybody under the same conditions in society.
  2. The emergence of psychotic symptoms in the absence of a traumatic incident that would be stressful for anyone under the same conditions in society is referred to as BPD without an obvious stressor.
  3. BPD with postpartum onset within four weeks post-childbirth is defined as the beginning of psychiatric problems.

Possible causes of Brief Psychotic Disorder (BPD)?

Although the precise cause of BPD is unknown, it is considered to be caused by a combination of genetic, biological, environmental, and psychological factors.

  • The disease is more frequent in individuals with a family history of psychosis or mood disorders, such as depression or bipolar disorder, it is conceivable that there is a genetic relationship.
  • Inadequate coping abilities may cause the illness as a defense or escape from a terrifying or stressful circumstance.
  • In most cases, a severely stressful or traumatic incident triggers the condition.
  • Short reactive psychosis has been discovered to be induced by extremely stressful events, such as imprisonment in confinement.
  • Childbirth might be a trigger for some women.

Treatment options for Brief Psychotic Disorder (BPD):

Current treatment guidelines for BPD focus on pharmaceutical and psychotherapy. 

Pharmacotherapy

Antipsychotics, particularly second-generation antipsychotics, are the first choice for acute psychotic illness. Although BPD often results in full resolution of symptoms within one month of symptom onset, it is recommended that antipsychotic therapy should be continued for one to three months following symptom remission. Oral medications are preferred but there are also first-line intramuscular injections available. 

  • Second-generation or atypical antipsychotics: Second-generation antipsychotics include quetiapine, paliperidone, olanzapine, risperidone, aripiprazole, ziprasidone, and clozapine, which are recommended because of their lower risk of extrapyramidal symptoms.
  • Antipsychotics of the first generation, often known as typical antipsychotics: First-generation medicines include trifluoperazine, fluphenazine, haloperidol, chlorpromazine, and thioridazine. Extrapyramidal symptoms (EPS) such as acute dystonia, akathisia, cogwheel stiffness, and tardive dyskinesia are some of the most notable side effects to be aware of when using this medication.

Cognitive Behavioral Therapy (CBT)

Cognitive Behavioral Therapy (CBT) may help prevent psychotic symptoms in those who have risk factors for developing psychosis but they have yet to experience a psychotic episode.

For those who have had a brief psychotic episode, offering support and education regarding their loved one’s condition has been shown to be highly beneficial in preventing recurring psychotic symptoms in individuals with the disorder.

Preterm delivery of pregnancies or avoidance of future pregnancies for women who have experienced severe psychotic episodes has been proven to help prevent recurrent episodes of the illness in the form of postpartum psychosis.