Brief Psychotic Disorder Differential Diagnoses
- Author: Mohammed A Memon, MD; Chief Editor: David Bienenfeld, MD more...
In addition to the conditions listed in the differential diagnosis, other problems to be considered include the following:
Substance-induced psychotic disorder
Mood disorder with psychotic features
Psychotic disorder not otherwise specified (NOS)
Psychosis associated with personality disorders
The history, the physical examination, and laboratory tests can help differentiate brief psychotic disorder from psychotic disorder secondary to general medical condition, delirium, and various other disorders. (See Presentation and Workup.)
The occurrence of a psychotic episode during a full affective episode excludes the diagnosis of brief psychotic disorder. If psychotic symptoms persist for longer than 1 month, schizophreniform disorder, schizoaffective disorder, schizophrenia, delusional disorder, mood disorder with psychotic features, or psychotic disorder NOS are the most important possibilities to be considered. Rapidly changing delusions and rapidly changing mood also help differentiate brief psychotic disorder from schizophrenia, schizoaffective disorder, and delusional disorder.
In the case of malingering, there is usually some evidence indicating that the illness was feigned for an understandable goal. In factitious disorder, the history may reveal that the symptoms were intentionally produced. The presence of a florid psychosis makes the diagnosis of dissociative disorder unlikely.
Psychological stressors in individuals with personality disorders may precipitate brief periods of psychotic symptoms. In such cases, if symptoms persist for longer than 1 day, an additional diagnosis of brief psychotic disorder may be considered.
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Washington, DC: American Psychiatric Association; 2013.
Chaudron LH, Pies RW. The relationship between postpartum psychosis and bipolar disorder: a review. J Clin Psychiatry. 2003 Nov. 64(11):1284-92. [Medline].
Valdimarsdottir U, Hultman CM, Harlow B, Cnattingius S, Sparen P. Psychotic illness in first-time mothers with no previous psychiatric hospitalizations: a population-based study. PLoS Med. 2009 Feb 10. 6(2):e13. [Medline].
Susser E, Fennig S, Jandorf L, Amador X, Bromet E. Epidemiology, diagnosis, and course of brief psychoses. Am J Psychiatry. 1995 Dec. 152(12):1743-8. [Medline].
Susser E, Wanderling J. Epidemiology of nonaffective acute remitting psychosis vs schizophrenia. Sex and sociocultural setting. Arch Gen Psychiatry. 1994 Apr. 51(4):294-301. [Medline].
Jorgensen P, Mortensen PB. Reactive psychosis and mortality. Acta Psychiatr Scand. 1990 Mar. 81(3):277-9. [Medline].
Correll CU, Smith CW, Auther AM, McLaughlin D, Shah M, Foley C, et al. Predictors of remission, schizophrenia, and bipolar disorder in adolescents with brief psychotic disorder or psychotic disorder not otherwise specified considered at very high risk for schizophrenia. J Child Adolesc Psychopharmacol. 2008 Oct. 18(5):475-90. [Medline].
Jorgensen P, Bennedsen B, Christensen J, Hyllested A. Acute and transient psychotic disorder: comorbidity with personality disorder. Acta Psychiatr Scand. 1996 Dec. 94(6):460-4. [Medline].
Karagianis JL, Dawe IC, Thakur A, et al. Rapid tranquilization with olanzapine in acute psychosis: a case series. J Clin Psychiatry. 2001. 62 Suppl 2:12-6. [Medline].
Brook S, Lucey JV, Gunn KP. Intramuscular ziprasidone compared with intramuscular haloperidol in the treatment of acute psychosis. Ziprasidone I.M. Study Group. J Clin Psychiatry. 2000 Dec. 61(12):933-41. [Medline].