Patients who experience an acute psychotic episode lasting longer than
one day but less than one month and that may or may not immediately
follow an important life stress or a pregnancy (with postpartum
onset). This illness usually comes as a surprise as there is no
forewarning that the person is likely to "break down," although
this disorder is more common in people with a pre-existing personality
disorder (particularly histrionic
types). The main diagnostic criteria is as follows:
The patient has at least one of the following that is not a culturally
Speech that is markedly disorganized
Behavior that is markedly disorganized
The patient has symptoms from 1 to 30 days and eventually recovers completely.
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.,
drug of abuse, a medication) or a general medical condition.
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.
Postpartum Onset: if onset within 4 weeks postpartum.
or Sexual Dysfunction.
Some disorders have similar or even the same symptom. The clinician,
therefore, in his diagnostic attempt has to differentiate against the
following disorders which he needs to rule out to establish a precise
Psychotic Disorder Due to a General Medical Condition or a Delirium.
Delirium and Substance Intoxication.
Mood Disorder With Psychotic
Factitious Disorder, With Predominantly
Psychological Signs and Symptoms.
Psychotic Disorder Not Otherwise Specified.
disorder (also known as brief reactive psychosis) is a short-term break
from reality. The disorder usually strikes people between 20 and 30
years of age. With treatment, symptoms usually disappear within a month.
However, a short hospitalization may be necessary. A brief psychotic
episode is usually triggered by a traumatic event such as a death, assault,
or rape. Previous emotional problems increase the possibility of an
episode. Some women develop the problem after giving birth. The disorder
is NOT brought on by physical illness, and is not a reaction to drugs.
Treatment for an
acute attack can require full-time hospitalization in a locked inpatient
and Psychotherapy [ See
Therapy Section ]:
Group Therapy: These
meetings are somewhat like a support group session, allowing patients
to share coping strategies. The meetings are run by medical staff.
Therapy: This is a time for you to meet alone with your therapist
to discuss ways of dealing with the illness.
Therapy: For patients who become severely withdrawn or depressed, this
form of treatment can help speed recovery. Also known as ECT or shock
therapy, it applies a mild electric current to the brain. Although the
treatment temporarily disrupts the memory, full recall typically returns
within 2 weeks.
[ See Psychopharmacology
Section ] :
medications will usually bring an end to the episode. However, a short
hospital stay may be necessary.
Special Antipsychotic Adverse Reactions
Syndrome. May occur at any point during the course of treatment. Includes
symptoms of autonomic instability, altered mental status, which may
progress to hyperthermia, stupor, and muscle hypertonicity. Death may
Involuntary movements of the tongue, face, mouth, or jaw associated
with long-term administration of antipsychotics. Elderly females at
highest risk. May be irreversible.