Brief Psychotic Disorder 95
terion B). The disturbance is not better explai ned by a depressive or bipolar disorder with
psychotic features, by schizoaffective disorder , or by schizophrenia and is not attributable
to the physiological effects of a substance (e .g., a hallucinogen) or  another medical condi-
tion (e.g., subdural hematoma) (Criterion C).
In addition to the five symptom domain areas identified in the diagnostic criteria, the
assessment of cognition, depression, and mani a symptom domains is vital for making crit-
ically important distinctions between the va rious schizophrenia spectrum and other psy-
chotic disorders.
Associated Features Supporting Diagnosis
Individuals with brief psychoti c disorder typically experience  emotional turmoil or over-
whelming confusion. They may have rapid sh ifts from one intense affect to another.
Although the disturbance is brief, the level of  impairment may be severe, and supervision
may be required to ensure that nutritional and hygienic needs are met and that the indi-
vidual is protected from the consequences of poor judgment, cognitive impairment, or act-
ing on the basis of delusions. There appears to  be an increased risk of suicidal behavior,
particularly during the acute episode.
Prevalence
In the United States, brief psychotic disorder  may account for 9% of cases of first-onset
psychosis. Psychotic disturbances that meet Crit eria A and C, but not Criterion B, for brief
psychotic disorder (i.e., duration of active symptoms is 1–6 months  as opposed to remis-
sion within 1 month) are more common in developing countries than in developed coun-
tries. Brief psychotic diso rder is twofold more common in females than in males.
Development and Course
Brief psychotic disorder may appear in adolescence or early adulthood, and onset can oc-