Besande, Jhoanna Faye B.

BSN III-A

RLE 105A Clinical Instructor: Ms. Liezel Amor B. Mauro

BRIEF PSYCHOTIC DISORDER - a short-term illness with psychotic symptoms. The symptoms often come on suddenly, but last for less than one month, after which the person usually recovers completely. There are three basic forms of brief psychotic disorder:

Brief psychotic disorder with obvious stressor (also called brief reactive psychosis): This type, also called brief reactive psychosis, occurs shortly after and often in response to a trauma or major stress, such as the death of a loved one, an accident, assault, or a natural disaster. Most cases of brief psychotic disorder occur as a reaction to a very disturbing event. Brief psychotic disorder without obvious stressor: With this type, there is no apparent trauma or stress that triggers the illness. Brief psychotic disorder with postpartum onset: This type occurs in women, usually within 4 weeks of having a baby.

The most obvious symptoms of brief psychotic disorder include:

Hallucinations: Hallucinations are sensory perceptions of things that aren't actually present, such as hearing voices, seeing things that aren't there, or feeling sensations on your skin even though nothing is touching your body. Delusions: These are false beliefs that the person refuses to give up, even in the face of contradictory facts.

Other symptoms of brief psychotic disorder include:

Disorganized thinking Speech or language that doesn't make sense Unusual behavior and dress Problems with memory Disorientation or confusion Changes in eating or sleeping habits, energy level, or weight Inability to make decisions

DSM IV-TR Criteria for Brief Psychotic Disorder A. Presence of one (or more) of the following symptoms: (1) delusions (2) hallucinations (3) disorganized speech (e.g., frequent derailment or incoherence)

(4) grossly disorganized or catatonic behavior Note: Do not include a symptom if it is a culturally sanctioned response pattern. B. Duration of an episode of the disturbance is at least 1 day but less than 1 month, with eventual full return to premorbid level of functioning. C. The disturbance is not better accounted for by a Mood Disorder With Psychotic Features, Schizoaffective Disorder, or Schizophrenia and is not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition. Specify if: With Marked Stressor(s) (brief reactive psychosis): if symptoms occur shortly after and apparently in response to events that, singly or together, would be markedly stressful to almost anyone in similar circumstances in the person's culture Without Marked Stressor(s): if psychotic symptoms do not occur shortly after, or are not apparently in response to events that, singly or together, would be markedly stressful to almost anyone in similar circumstances in the person's culture With Postpartum Onset: if onset within 4 weeks postpartum CAUSES The exact cause of brief psychotic disorder is not known. One theory suggests a genetic link, because the disorder is more common in people who have family members with mood disorders, such as depression or bipolar disorder. Another theory suggests that the disorder is caused by poor coping skills, as a defense against or escape from a particularly frightening or stressful situation. These factors may create a vulnerability to develop brief psychotic disorder. In most cases, the disorder is triggered by a major stress or traumatic event. Childbirth may trigger the disorder in some women.

Brief psychotic disorder is uncommon. It generally first occurs in early adulthood (20s and 30s), and is more common in women than in men. People who have a personality disorder -- such as antisocial personality disorder or paranoid personality disorder -- are more prone to developing brief psychotic disorder.

DIAGNOSIS If symptoms of brief psychotic disorder are present, the doctor will perform a complete medical history and physical exam. Although there are no laboratory tests to specifically diagnose brief psychotic disorder, the doctor may use various tests -such as as brain imaging (e.g., MRI scans) or blood tests - to rule out physical illness as the cause of the symptoms.

If the doctor finds no physical reason for the symptoms, he or she may refer the person to a psychiatrist or psychologist, mental health professionals who are trained to diagnose and treat mental illnesses. Psychiatrists and psychologists use specially designed interview and assessment tools to evaluate a person for a psychotic disorder.

TREATMENT Treatment for brief psychotic disorder typically includes psychotherapy (a type of counseling) and/or medication. Hospitalization may be necessary if the symptoms are severe or if there is a risk that the person may harm him or herself, or others.

Medication: Antipsychotic drugs may be prescribed to decrease or eliminate the symptoms and end the brief psychotic disorder. Conventional antipsychotics include: Thorazine, Prolixin, Haldol,Navane, Stelazine, Trilafon and Mellaril. Newer medications, called atypical antipsychotic drugs, include: Risperdal, Seroquel, Geodon and Zyprexa. Tranquilizers such as Ativan or Valium may be used if the person has a very high level of anxiety (nervousness) and/or problems sleeping. Psychotherapy: Psychotherapy helps the person identify and cope with the situation or event that triggered the disorder.