Which of the following is NOT typically listed as a differential diagnosis for Brief Psychotic Disorder?

• A. Malingering
• B. Factitious Disorder
• C. Autism Spectrum Disorder
• D. Substance-Related Disorders

Answer: (C)

Brief Psychotic Disorder is marked by a sudden onset of one or more psychotic symptoms (such as delusions, hallucinations, disorganized speech, or disorganized behavior) that lasts at least a day but less than a month, with full return to premorbid functioning. In evaluating this presentation, clinicians consider conditions that could mimic or explain these acute psychotic features, including other psychotic disorders, mood disorders with psychosis, substance-induced psychosis, and certain disorders where feigning or external factors might play a role.

Autism Spectrum Disorder is not typically listed as a differential for brief psychotic disorder because its core features are neurodevelopmental and persistent from early life: impairments in social communication and interaction, along with restricted and repetitive patterns of behavior. These traits are longstanding and present well before any acute psychotic episode, and they do not characteristically wax and wane over a short course as seen in a brief psychotic episode. In contrast, the other considerations—malingering, factitious disorder, and substance-related disorders—are more plausible when evaluating an acute, transient psychotic presentation, since they relate to symptom production, external incentives, or substance effects that can produce acute psychotic-like symptoms.