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Brief reactive psychosis

Brief reactive psychosis is a sudden, short-term display of psychotic behavior, such as hallucinations or delusions, that occurs with a stressful event.

Causes, incidence, and risk factors

Brief reactive psychosis is triggered by extreme stress (such as a traumatic accident or loss of a loved one), and is followed by a return to the previous level of function. The person may or may not be aware of the strange behavior.

This condition most often affects people in their 20s, 30s, and 40s. People who have personality disorders are at greater risk for having a brief reactive psychosis.

Symptoms

Symptoms of brief reactive psychosis may include the following:

  • Disorganized behavior
  • False ideas about what is taking place (delusions)
  • Hearing or seeing things that aren't real (hallucinations)
  • Strange speech or language

The symptoms are not due to alcohol or other drug abuse and they last longer than a day, but less than a month.

Signs and tests

A psychiatric evaluation can confirm the diagnosis. A physical exam and laboratory testing can rule out medical illness as the cause of the symptoms.

Treatment

By definition, psychotic symptoms go away on their own in less than 1 month. In some cases, however, brief reactive psychosis can be the beginning of a more chronic psychotic condition, such as schizophrenia or schizoaffective disorder . Antipsychotic drugs can help decrease or stop the psychotic symptoms.

Talk therapy may also help you cope with the emotional stress that triggered the problem.

Expectations (prognosis)

Most people with this disorder have a good outcome. Repeat episodes may occur in response to stress.

Complications

As with all psychotic illnesses, this condition can severely disrupt your life and possibly lead to violence and suicide.

Calling your health care provider

Call for an appointment with a mental health professional if you have symptoms of this disorder. If you are concerned for your safety or for the safety of someone else, call the local emergency number (such as 911) or go immediately to the nearest emergency room.

References

Freudenriech O, Weiss AP, Goff DC. Psychosis and schizophrenia. In: Stern TA, Rosenbaum JF, Fava M, Biederman J, Rauch SL, eds. Massachusetts General Hospital Clinical Psychiatry. 1st ed. Philadelphia, Pa: Mosby Elsevier; 2008:chap 28.

Updated: 3/7/2012

Fred K. Berger, MD, Addiction and Forensic Psychiatrist, Scripps Memorial Hospital, La Jolla, California. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.


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