Brief psychotic disorder

Overview 
Theory 
Diagnosis 
Management 
Follow up 
Resources 

Case history #1

A 28-year-old man, who has no prior history of psychiatric illness, receives a very prestigious, and unexpected, promotion at work. He feels that a colleague of his was more deserving. He becomes convinced that this colleague is envious of his promotion and that the colleague is therefore planning to sabotage him. His fears generalize to all his coworkers and he begins to avoid work because of his paranoia. After 2 weeks of this behavior, he makes a request to his boss to have the locks in his office changed, as he is certain that his coworkers are planning to steal his files in order to get him into trouble. His boss recommends that he seek medical attention. He does so, and is treated with an antipsychotic drug. His symptoms resolve within 1 week and he is able to function at work again without feeling paranoid.

Case history #2

A 27-year-old woman, accompanied by her husband, presents 2 weeks after giving birth to a healthy baby girl. Her husband claims that she accuses him of trying to kidnap their daughter. She reports hearing voices telling her that her husband is trying to take the baby and that she should "escape" with her daughter to live elsewhere. She is placed on a low dose of olanzapine and her symptoms are monitored. The baby is monitored for adverse effects because the mother is breastfeeding. After 2 weeks of treatment and monitoring, the symptoms have resolved. The symptoms have not returned by her 1-month follow-up visit.

Other presentations

Brief psychotic disorder can present with or without a marked stressor as well as during pregnancy or within 4 weeks postpartum. Typically a person will present with hallucinations or delusional behavior. However, disorganized speech (e.g., frequent derailment or incoherence in conversation) or catatonic behavior may be the presenting and prominent features. A possible relationship between COVID-19 and brief psychotic disorder has been noted, and an increase in brief psychotic disorder was seen during the COVID-19 pandemic.[2][3][4][5]

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