MENTAL HEALTH BASICS



Brief Psychotic Disorder

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 and borderline types). The main
diagnostic criteria is as follows:



The patient has at least one of the following that is not a culturally
sanctioned response:



Delusions

Hallucinations

Speech that is markedly disorganized

Behavior that is markedly disorganized or catatonic.



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., 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.



Associated Features:



Learning Problem.

Hypoactivity.

Psychotic.

Euphoric Mood.

Depressed Mood.

Somatic or Sexual Dysfunction.

Hyperactivity.



Differential Diagnosis:



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 diagnosis.



Psychotic Disorder Due to a General Medical Condition or a Delirium.

Substance-Induced Psychotic Disorder.

Substance-Induced Delirium and Substance Intoxication.

Mood Episode.

Schizophreniform Disorder.

Delusional Disorder.

Mood Disorder With Psychotic Features.

Factitious Disorder, With Predominantly Psychological Signs and Symptoms.

Malingering.

A Personality Disorder.

Psychotic Disorder Not Otherwise Specified.



Cause:



Brief psychotic 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:



Treatment for an acute attack can require full-time hospitalization in a locked
inpatient unit.



Counseling and Psychotherapy:



Group Therapy: These meetings are somewhat like a support group session,
allowing patients to share coping strategies. The meetings are run by medical
staff.



Individual Therapy: This is a time for you to meet alone with your therapist to
discuss ways of dealing with the illness.



Medical Treatments:



Electroconvulsive 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.



Pharmacotherapy :



Antipsychotic medications will usually bring an end to the episode. However, a
short hospital stay may be necessary.



Antipsychotics (typical)



Chlorpromazine (Thorazine).

Thioridazine (Mellaril).

Trifluoperazine (Stelazine).

Thiothixene (Navane).

Fluphenazine (Prolixin).

Haloperidol (Haldol).



Antipsychotics (atypical)



Risperidone (Risperdal).

Olanzapine (Zyprexa).

Clozapineł (Clozaril).



Special Antipsychotic Adverse Reactions



Neuroleptic Malignant 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
occur.



Tardive Dyskinesia. Involuntary movements of the tongue, face, mouth, or jaw
associated with long-term administration of antipsychotics. Elderly females at
highest risk. May be irreversible.





http://www.psychnet-uk.com/dsm_iv/brief_psychotic_episode.htm













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