eMedicine Specialties > Psychiatry > Emergency

Brief Psychotic Disorder: Follow-up

Author: Mohammed A Memon, MD, Medical Director of Geriatric Psychiatry, Department of Psychiatry, Spartanburg Regional Hospital System
Coauthor(s): Michael Larson, DO, Clinical Instructor, Department of Child and Adolescent Psychiatry, Harvard University
Contributor Information and Disclosures

Updated: May 15, 2009

Follow-up

Further Inpatient Care

Further inpatient care is unnecessary once the acute attack has ended.

Further Outpatient Care

Individual, family, and group psychotherapy may be considered to help cope with stressors and to help resolve conflict.

Prognosis

  • Generally, brief psychotic disorder has a good prognosis and runs its course in less than a month. A good prognosis is usually associated with sudden onset, short duration of symptoms, and good premorbid adjustment.
    • According to European studies, 50-80% of all patients have no further major psychiatric problems.
    • Patients with no premorbid psychiatric history have been associated with excellent prognosis. Therefore, educating the patient and the patient's family about the situation is essential.
  • Patients may be at risk of committing suicide during psychotic episodes, especially when brief psychotic disorder is associated with affective symptoms.
  • Some data indicate that brief psychotic episode with an acute onset may be an early manifestation of severe mental disorder (eg, affective disorders).9

Patient Education

Both the patient and the family must be educated about the illness and potential adverse effects of the medications. Helpful Web sites include the following:

Miscellaneous

Medicolegal Pitfalls

  • Missing an underlying medical etiology of psychosis is a potential medicolegal problem. General recommendations include serious consideration of medical causes in any acute onset new psychosis. This does not necessarily mean ordering every possible test, but history and physical examination often alert the clinician to the need for additional medical evaluation.
  • Physical or chemical restraints may be necessary in cases of severe, uncontrolled agitation to provide safety to self and/or others.
 


More on Brief Psychotic Disorder

Overview: Brief Psychotic Disorder
Differential Diagnoses & Workup: Brief Psychotic Disorder
Treatment & Medication: Brief Psychotic Disorder
Follow-up: Brief Psychotic Disorder
References
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References

  1. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR). 4th ed. Washington DC:. American Psychiatric Press;2000.

  2. Susser E, Wanderling J. Epidemiology of nonaffective acute remitting psychosis vs schizophrenia. Sex and sociocultural setting. Arch Gen Psychiatry. Apr 1994;51(4):294-301. [Medline].

  3. Jorgensen P, Mortensen PB. Reactive psychosis and mortality. Acta Psychiatr Scand. Mar 1990;81(3):277-9. [Medline].

  4. Chaudron LH, Pies RW. The relationship between postpartum psychosis and bipolar disorder: a review. J Clin Psychiatry. Nov 2003;64(11):1284-92. [Medline].

  5. [Best Evidence] 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. Feb 10 2009;6(2):e13. [Medline].

  6. Jorgensen P, Bennedsen B, Christensen J, Hyllested A. Acute and transient psychotic disorder: comorbidity with personality disorder. Acta Psychiatr Scand. Dec 1996;94(6):460-4. [Medline].

  7. 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].

  8. 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. Dec 2000;61(12):933-41. [Medline].

  9. 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. Oct 2008;18(5):475-90. [Medline].

  10. Beighley PS, Brown GR, Thompson JW Jr. DSM-III-R brief reactive psychosis among Air Force recruits. J Clin Psychiatry. Aug 1992;53(8):283-8. [Medline].

  11. Jablensky A, Sartorius N, Ernberg G, et al. Schizophrenia: manifestations, incidence and course in different cultures. A World Health Organization ten-country study. Psychol Med Monogr Suppl. 1992;20:1-97. [Medline].

  12. Jauch DA, Carpenter WT Jr. Reactive psychosis. I. Does the pre-DSM-III concept define a third psychosis?. J Nerv Ment Dis. Feb 1988;176(2):72-81. [Medline].

  13. Jauch DA, Carpenter WT Jr. Reactive psychosis. II. Does DSM-III-R define a third psychosis?. J Nerv Ment Dis. Feb 1988;176(2):82-6. [Medline].

  14. Johnson FA. African perspective on mental disorder. In: Mezzich JE, Honda Y, Kastrup MC, eds. Psychiatric Diagnosis: A World Perspective. New York, NY: Springer Verlag; 1994.

  15. Jorge MR, Mezzich JE. Latin American contributions to psychiatric nosology and classification. In: Mezzich JE, Honda Y, Kastrup MC, eds. Psychiatric Diagnosis: A World Perspective. New York, NY: Springer Verlag; 1994.

  16. Jorgensen P, Jensen J. An attempt to operationalize reactive delusional psychosis. Acta Psychiatr Scand. Nov 1988;78(5):627-31. [Medline].

  17. Karno M, Jenkins JH. Cultural considerations in the diagnosis of schizophrenia and related disorders and psychotic disorders not otherwise classified. In: TA Widiger, ed. DSM-IV Source Book. Washington DC: American Psychiatric Press; 1994.

  18. Lin KM. Cultural influences on the diagnosis of psychotic and organic disorders. In: Mezzich JE, Kleinman A, Horacio F, Parron DL, eds. Culture and Psychiatric Diagnosis: A DSM-IV Perspective. Washington DC: American Psychiatric Press; 1996.

  19. Mezzich JE, Lin KM. Acute and transient psychotic disorders and culture-bound syndromes. In: Sadock BJ, Sadock VA, eds. Kaplan and Sadock's Comprehensive Textbook of Psychiatry. 6th ed. Baltimore, Md: Lippincott Williams & Wilkins; 1995:1049.

  20. Pull CB, Chaillet G. The nosological views of French-speaking psychiatry. In: Mezzich JE, Honda Y, Kastrup MC, eds. Psychiatric Diagnosis: A World Perspective. New York, NY: Springer Verlag; 1994.

  21. Vanderhart O, Witztum E, Friedman B. From hysterical psychosis to reactive dissociative psychosis. J Trauma Stress. 1993;6:43.

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Further Reading

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Keywords

brief reactive psychosis, hysterical psychosis, reactive schizophrenia, transient psychosis, acute and transient psychotic disorders, ATPD, atypical psychosis, stress psychosis, psychogenic psychosis, cycloid psychosis, good-prognosis schizophrenia, yak, latah, koro, amok, whitiligo, thought disturbances, mood disturbances, mood disorders, substance-induced psychosis, bouffee delirante

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Contributor Information and Disclosures

Author

Mohammed A Memon, MD, Medical Director of Geriatric Psychiatry, Department of Psychiatry, Spartanburg Regional Hospital System
Mohammed A Memon, MD is a member of the following medical societies: American Association for Geriatric Psychiatry, American Medical Association, and American Psychiatric Association
Disclosure: Nothing to disclose.

Coauthor(s)

Michael Larson, DO, Clinical Instructor, Department of Child and Adolescent Psychiatry, Harvard University
Michael Larson, DO is a member of the following medical societies: American Academy of Addiction Psychiatry and American Academy of Child and Adolescent Psychiatry
Disclosure: Nothing to disclose.

Medical Editor

Alan D Schmetzer, MD, Professor, Vice-Chair for Education, and Director of Residency Training in General and Addiction Psychiatry, Department of Psychiatry, Indiana University School of Medicine
Alan D Schmetzer, MD is a member of the following medical societies: American Academy of Addiction Psychiatry, American Academy of Clinical Psychiatrists, American Academy of Psychiatry and the Law, American College of Physician Executives, American Medical Association, American Neuropsychiatric Association, American Psychiatric Association, and Association for Convulsive Therapy
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

David Bienenfeld, MD, Vice-Chair, Program Director, Professor, Department of Psychiatry, Wright State University School of Medicine
David Bienenfeld, MD is a member of the following medical societies: American Medical Association, American Psychiatric Association, and Association for Academic Psychiatry
Disclosure: Nothing to disclose.

CME Editor

Harold H Harsch, MD, Program Director of Geropsychiatry, Department of Geriatrics/Gerontology, Associate Professor, Department of Psychiatry and Department of Medicine, Froedtert Hospital, Medical College of Wisconsin
Harold H Harsch, MD is a member of the following medical societies: American Psychiatric Association
Disclosure: lilly Honoraria Speaking and teaching; Forest Labs Honoraria Speaking and teaching; AstraZeneca Honoraria Speaking and teaching; Pfizer Grant/research funds Speaking and teaching; Northstar Grant/research funds Research; Novartis Grant/research funds research; Pfizer  Speaking and teaching; Sanofi-avetis Grant/research funds research; Otsuke Grant/research funds reseach; GlaxoSmithKline Grant/research funds research

Chief Editor

Stephen Soreff, MD, President of Education Initiatives, Nottingham, NH; Faculty, Metropolitan College of Boston University, Boston, MA
Stephen Soreff, MD is a member of the following medical societies: American College of Mental Health Administration and American Psychosomatic Society
Disclosure: Nothing to disclose.

 
 
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