Brief Psychotic Disorder: Symptoms And Treatments

When can we say that a person is “crazy?”  How do we define madness? There are many definitions given in this regard and there are also many and varied different points of view on the phenomenon of madness. In this article, we will represent her through brief psychotic disorder.

Traditionally, in psychiatry, the large groups of disorders are divided into two: psychotic disorders and neurotic disorders. In general, we can define madness as a psychotic state.

Psychoses or psychotic states imply a loss of contact with reality manifested through delusions and/or hallucinations. On the contrary, neuroses or neurotic states do not imply a loss of contact with reality. Examples of neurotic disorders would be depression and anxiety, and classic examples of psychosis would be schizophrenia and bipolar disorder.

Characteristics that define psychotic disorders: delusions and hallucinations

To talk about a psychotic disorder, such as a brief psychotic disorder, is to talk about its manifestations or symptoms. In brief psychotic disorder, there are two types of changes in the perception of reality: delusions and hallucinations.

When we speak of delusions, we are referring to fixed beliefs that are not sensitive to reality, to evidence against them. Etymologically the word delirium derives from the Latin term deliare which means to get out of the furrow of the plow. Applied to thinking, it would be something like “thinking outside the box”.

In the lay sense, delusion means “to be mad, to have one’s reason disturbed”. In the usual language, delusion is practically synonymous with madness, irrationality, madness or loss of reality.

Characteristics of delusions

To identify a delusion as such, we must take into account the degree to which the experience fits the following points:

• It is maintained with absolute conviction.
• It is experienced as a self-evident truth.
• They don’t let themselves be changed by reason or experience.
• Its content is fantastic or at least intrinsically improbable.
• Beliefs are not shared by other members of the social or cultural group.
• The person is preoccupied with the belief and it is difficult for him to think or talk about it.
• Belief is a source of subjective discomfort or interferes with the person’s social functioning and occupations.

In short, delusions are characterized by being conceptually very complex, and perhaps that is why it is so difficult to “trap” them in a definition. A classic example of delusion would be the person who is convinced that he is being watched or controlled through hidden cameras. Or the one who believes she is Napoleon. Or the one who thinks she has a divine mission to save the world from its destruction.

What do we mean by hallucination?

Hallucinations are perceptions that arise in the presence of an external stimulus. They are vivid and clear, with all the force and impact of normal perceptions, and not subject to voluntary control.

Hallucinations can occur in any sensory modality, but auditory hallucinations are the most common in brief psychotic disorder and schizophrenia. These hallucinations usually take the form of voices, known or unknown, that are perceived as different from thought itself.

Classic examples of hallucinations can be identified in people who hear voices telling them that they must carry out a mission. Or the ones who see small animals crawling through their arms.

The Brief Psychotic Disorder

The essential feature of brief psychotic disorder is an alteration that implies the sudden onset of at least one of the following psychotic symptoms: delusions, hallucinations, disorganized speech or speech, or very anomalous psychomotor behavior, including catatonia. Catatonia can be defined as a neuropsychiatric syndrome characterized by motor anomalies that are associated with alterations in consciousness, affection and thinking.

Seizures may occur, but they are more frequent when the cause is organic. Ultimately (in both organic and psychiatric cases), catatonia is thought to have its origins in dysfunction of the lateral orbitofrontal cortex.

The sudden onset of brief psychotic disorder is with a change from a non-psychotic state to a clearly psychotic state within a 2-week period. An episode of the disorder lasts for at least 1 day, but less than 1 month, and the individual completely returns to the level of functioning that they had before the disorder.

Characteristics of Brief Psychotic Disorder

According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-V), for a person to be diagnosed with brief psychotic disorder, the following criteria must be met:

A. Presence of one (or more) of the following symptoms. At least one of them must be (1), (2) or (3):

• Delusions.
• Hallucinations.
• Disorganized speech (disorganized speech).
• Very disorganized or catatonic behavior.

B. The duration of an episode of disorder is at least one day and less than one month, with full final return to the previous degree of disease functioning.

C. The disorder cannot be explained as a depressive or bipolar disorder with psychotic features, or another psychotic disorder such as schizophrenia or catatonia, and cannot be attributed to the physiological effects of a substance (eg, a drug or medication) or other medical problem.

As we have seen, a person who has a brief psychotic disorder quickly moves from a state of “normality” to a psychotic state, almost without warning. This state of “madness” lasts between a day and a month (never longer). Finally, the person either recovers completely or returns to his normal level.

The differences with schizophrenia are clear. In schizophrenia, the ongoing signs of the disorder persist for at least six months, and usually the change from “normal” to “madness” is not so rapid, but more gradual. The course of schizophrenia is often chronic, whereas brief psychotic disorder is usually resolved or “cured.”

Although the disorder is brief, it can be serious.

People with a brief psychotic disorder typically experience emotional turmoil or severe confusion. They can show rapid changes from one intense state to another. Even though the disorder is brief, the degree of dysfunction in the period in which symptoms are present can be significant.

It may require supervision so that nutritional and hygienic needs are met and the person is protected from the consequences of lack of judgment, cognitive dysfunction, and delusion-motivated actions. On the other hand, during brief psychotic disorder there appears to be an increased risk of suicidal behavior, especially during an acute episode. It is essential in this case to take safety measures to prevent the affected person from getting hurt.

Treatment of brief psychotic disorder

Pharmacological treatment is the main intervention for psychosis, but treatment during the initial phase should not be based solely on it. Both psychosocial interventions and psychological therapy are very important in the recovery process.

These interventions encompass a series of measures with the objective of minimizing the patient’s vulnerability in the face of stressful situations, facilitating the recovery processes, strengthening their adaptation and family, social and training-work functioning, as well as increasing their resources to face the conflicts, problems and interpersonal or bibliographic tensions.

As we have seen, brief psychotic disorder can have important consequences for your sufferer. It can also deteriorate family and personal relationships. This makes your treatment by a qualified professional essential.

references

• American Psychiatry Association (2014). Diagnostic and statistical manual of mental disorders (DSM-5), 5th Ed. Madrid: Editorial Médica Panamericana.