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Last reviewed: 16 Mar 2025
Last updated: 21 Feb 2024

Summary

Definition

History and exam

Key diagnostic factors

  • presence of risk factors
  • at least 1 positive psychotic symptom lasting >1 day but <1 month
  • symptoms not due to substance use
  • symptoms not due to medical condition

Other diagnostic factors

  • pregnant or within 4 weeks postpartum
  • recent stress and trauma

Risk factors

  • significant life stressor
  • personality disorder
  • family history of psychotic disorder
  • pregnancy or 4 weeks postpartum
  • previous psychiatric symptoms in women
  • age 35 to 45 years
  • single mother

Diagnostic tests

1st tests to order

  • serum pregnancy test (females)

Tests to consider

  • electrolytes
  • BUN
  • creatinine
  • glucose
  • LFTs
  • TFTs
  • syphilis serology
  • urinalysis
  • urine toxicology
  • ECG
  • CT scan brain
  • MRI brain

Treatment algorithm

Contributors

Authors

Kimberly R. Warren, PhD

Associate Professor

Morgan State University

Department of Psychology

Baltimore

MD

Disclosures

KRW declares that she has no competing interests.

Elaine Weiner, MD

Assistant Professor

Outpatient Research Program

Department of Psychiatry

Maryland Psychiatric Research Center

University of Maryland

School of Medicine

Catonsville

MD

Disclosures

EW declares that she has no competing interests.

Deanna L. Kelly, PharmD

Associate Professor

Director

Treatment Research Program

Maryland Psychiatric Research Center

University of Maryland

School of Medicine

Department of Psychiatry

Catonsville

MD

Disclosures

DLK has served as a consultant for Alkermes and HLS Therapeutics.

Acknowledgements

Dr Kimberly Warren, Dr Elaine Weiner, and Dr Deanna Kelly would like to gratefully acknowledge Dr William R. Keller, a previous contributor to this topic.

Disclosures

WRK declares that he has no competing interests.

Peer reviewers

Joel Yager, MD

Professor

Department of Psychiatry

University of New Mexico School of Medicine

Albuquerque

NM

Disclosures

JY is an author of a reference cited in this topic.

Craig N. Sawchuk, PhD

Affiliate Assistant Professor

Department of Psychiatry and Behavioral Sciences

University of Washington Medical Center

Seattle

WA

Disclosures

CNS declares that he has no competing interests.

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