Brief psychotic disorder (BPD) is estimated to occur in 0.1% to 0.5% of the general population, and it is diagnosed in 2% to 7% of individuals that present with first-episode psychosis.[6]Castagnini A, Bertelsen A, Berrios GE. Incidence and diagnostic stability of ICD-10 acute and transient psychotic disorders. Comp Psychiatry. 2008;49:255-61.
http://www.ncbi.nlm.nih.gov/pubmed/18396184?tool=bestpractice.com
[7]Perala J, Suvisaari J, Saarni SI, et al. Lifetime prevalence of psychotic and bipolar I disorders in a general population. Arch Gen Psychiatry. 2007;64:19-28.
http://archpsyc.ama-assn.org/cgi/content/full/64/1/19
http://www.ncbi.nlm.nih.gov/pubmed/17199051?tool=bestpractice.com
[8]Fusar-Poli P, Salazar de Pablo G, Rajkumar RP, et al. Diagnosis, prognosis, and treatment of brief psychotic episodes: a review and research agenda. Lancet Psychiatry. 2022 Jan;9(1):72-83.
http://www.ncbi.nlm.nih.gov/pubmed/34856200?tool=bestpractice.com
Most studies report that BPD occurs more frequently in women; however, this remains controversial and may not be true for developing countries.[6]Castagnini A, Bertelsen A, Berrios GE. Incidence and diagnostic stability of ICD-10 acute and transient psychotic disorders. Comp Psychiatry. 2008;49:255-61.
http://www.ncbi.nlm.nih.gov/pubmed/18396184?tool=bestpractice.com
[7]Perala J, Suvisaari J, Saarni SI, et al. Lifetime prevalence of psychotic and bipolar I disorders in a general population. Arch Gen Psychiatry. 2007;64:19-28.
http://archpsyc.ama-assn.org/cgi/content/full/64/1/19
http://www.ncbi.nlm.nih.gov/pubmed/17199051?tool=bestpractice.com
[8]Fusar-Poli P, Salazar de Pablo G, Rajkumar RP, et al. Diagnosis, prognosis, and treatment of brief psychotic episodes: a review and research agenda. Lancet Psychiatry. 2022 Jan;9(1):72-83.
http://www.ncbi.nlm.nih.gov/pubmed/34856200?tool=bestpractice.com
[9]Jorgensen P, Bennedsen B, Christensen J. Acute and transient psychotic disorder: comorbidity with personality disorder. Acta Psychiatr Scand. 1996;94:460-4.
http://www.ncbi.nlm.nih.gov/pubmed/9021000?tool=bestpractice.com
BPD is more common in developing countries and in people with a personality disorder.[9]Jorgensen P, Bennedsen B, Christensen J. Acute and transient psychotic disorder: comorbidity with personality disorder. Acta Psychiatr Scand. 1996;94:460-4.
http://www.ncbi.nlm.nih.gov/pubmed/9021000?tool=bestpractice.com
[10]Susser E, Wanderling J. Epidemiology of nonaffective acute remitting psychosis vs schizophrenia. Sex and sociocultural setting. Arch Gen Psychiatry. 1994;51;294-301.
http://www.ncbi.nlm.nih.gov/pubmed/8161289?tool=bestpractice.com
[11]Ungvari GS, Mullen PE. Reactive psychoses revisited. Aust NZ J Psychiatry. 2000;34;458-67.
http://www.ncbi.nlm.nih.gov/pubmed/10881970?tool=bestpractice.com
There are 3 types of BPD:
With marked stressor(s): This type (formally called "brief reactive psychosis") is diagnosed when the psychotic symptoms occur in response to 1 or more events that would be considered markedly stressful to almost anyone in a similar situation in the individual’s culture.[1]American Psychiatric Association. Diagnostic and statistical manual of mental disorders, 5th ed. Text revision. (DSM-5-TR). Washington, DC: American Psychiatric Association; 2022. The incidence of this type of BPD in US Air Force recruits was found to be 1.4 per 100,000 after basic military training; however, these data were not collected during wartime.[12]Beighley PS, Brown GR, Thompson JW Jr. DSM-III-R brief reactive psychosis among Air Force recruits. J Clin Psychiatry. 1992;53:283-8.
http://www.ncbi.nlm.nih.gov/pubmed/1500405?tool=bestpractice.com
The incidence of this type of BPD in the US may have increased immediately after the terrorist attacks on 11 September 2001, although this is not known with any certainty. However, cases of BPD were reported in 2 individuals in northeastern US (far from New York), who experienced the attacks via media coverage.[13]Rushing SE, Jean-Baptiste M. Two cases of brief psychotic disorder related to media coverage of the September 11, 2001 events. J Psychiatric Prac. 2003;9:87-90.
http://www.ncbi.nlm.nih.gov/pubmed/15985919?tool=bestpractice.com
Without marked stressor(s): This type is diagnosed when the psychotic symptoms do not seem to be in response to a stressful event.[1]American Psychiatric Association. Diagnostic and statistical manual of mental disorders, 5th ed. Text revision. (DSM-5-TR). Washington, DC: American Psychiatric Association; 2022. The prevalence and incidence is unknown.
With peripartum onset: This type is diagnosed when the psychotic symptoms occur during pregnancy or within 4 weeks postpartum.[1]American Psychiatric Association. Diagnostic and statistical manual of mental disorders, 5th ed. Text revision. (DSM-5-TR). Washington, DC: American Psychiatric Association; 2022. It is estimated that 1 to 2 in 1000 women experience brief psychotic disorder with postpartum onset.[14]Engqvist, I, Nilsson A, Nilsson K, et al. Strategies in caring for women with postpartum psychosis: an interview study with psychiatric nurses. J Clin Nurs. 2007;16:1333-42.
http://www.ncbi.nlm.nih.gov/pubmed/1717584352?tool=bestpractice.com
[15]American College of Obstetricians and Gynecologists. Clinical practice guideline no. 4: screening and diagnosis of mental health conditions during pregnancy and postpartum. Jun 2023 [internet publication].
https://www.acog.org/clinical/clinical-guidance/clinical-practice-guideline/articles/2023/06/screening-and-diagnosis-of-mental-health-conditions-during-pregnancy-and-postpartum
A psychiatric hospitalization before delivery is associated with a higher incidence of BPD postpartum (9.3%), as is exposure to stress before childbirth.[16]Harlow BL, Vitonis AF, Sparen P, et al. Incidence of hospitalization for postpartum psychotic and bipolar episodes in women with and without prior pregnancy or prenatal psychiatric hospitalizations. Arch Gen Psychiatry. 2007;64:42-8.
http://www.ncbi.nlm.nih.gov/pubmed/17199053?tool=bestpractice.com
[17]Malhotra S, Malhotra S. Acute and transient psychotic disorders: comparison with schizophrenia. Curr Psychiatry Rep. 2003;5:178-86.
http://www.ncbi.nlm.nih.gov/pubmed/12773269?tool=bestpractice.com