INTRODUCTION :

                 Brief reactive psychosis follows a significant stressor in the patient’s life and symptoms last less than one month.
It is a rare disorder that occurs most often in adolescence and early adult-hood. It may be most common in persons in low socioeconomic groups and in patients with previously existing personality disorders. Persons who have experienced disasters or major cultural changes may also be at high risk.

CAUSES :

A significant psychosocial stressor is a causative factor for this disorder. However, many patients with the disorder have preexisting personality disorders, which may have both biological and psychological bases. Although schizophrenia has not been found to be more common in the relatives of persons with brief reactive psychosis, mood disorders may be more common among them. Psycho-dynamic formulations highlight inadequate coping mechanisms and the possibility of secondary gain in these patients. It has been hypothesized that the psychosis represents a defense, wish fulfillment, or escape related to the specific stressor.

CLINICAL FEATURES :-

The clinical signs and symptoms are similar to those seen in schizophrenia. Emotional volatility, outlandish dress or behavior, screaming and muteness, disorientation, and impaired recent memory may be present. The patient may be unable initially to relate the detail of the precipitating event but later may be able to relate the details.

COURSE AND PROGNOSIS :-

There are no prodromal symptoms before the precipitating stressor. The onset of symptoms is usually abrupt, following the stressor by as little as a few hours. The length of the acute and residual symptoms is often just a few hours or days and is always less than one month. Occasionally, depressive symptoms follow the resolution of the psychotic symptoms. Suicide is a concern during both the psychotic and the post psychotic depressive phases.

TREATMENT :-

Hospitalization may be necessary for the diagnosis and treatment of the psychosis. The support of the hospital environment may be enough to help the patient recover. Low dose of antipsychotic may be necessary in the first week of the treatment but can be withdrawn as early as possible. Individual, family and group psychotherapy addresses the significance of the specific stress and bolsters established coping mechanisms and encourages new ones. These help the patient cope with the loss of self esteem and confidence. Hypnotic medications may be useful during the first two to three weeks of the disorder.