Diagnostic Considerations
In addition to the conditions listed in the differential diagnosis, other problems to be considered include the following:
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Substance-induced psychotic disorder
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Mood disorders like major depression and bipolar disorder with psychotic features
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Unspecified schizophrenia spectrum and other psychotic disorder like schizophrenia, schizophreniform disoder, and delusional disorder
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Psychosis associated with personality disorders
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Other medical conditions, for example, delirium, seizure disorder, cushings syndrome, brain tumors, etc.
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Malingering and factitious disoders
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 unspecified psychotic disorders 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.
Differential Diagnoses
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Schizophreniform Disorder
