NBME Form 7 Practice Test

A sudden, short-lived psychotic episode triggered by a major stressor fits a brief psychotic disorder. In this setting, the person develops psychotic symptoms—here, auditory hallucinations and confusion—soon after a severe life event (the death of his wife). The key features are abrupt onset and a duration of less than one month with a full return to baseline functioning after the episode. Delirium would require a disturbance of attention and global cognitive impairment with fluctuating consciousness, usually tied to an identifiable medical illness or substance; that pattern isn’t described here. Mania would present with elevated mood, increased energy, decreased need for sleep, or grandiosity, which aren’t noted. Schizoaffective disorder requires a mood episode concurrent with psychotic symptoms plus a substantial period of psychosis without mood symptoms, which isn’t indicated in this scenario. So the presentation most consistent with a brief psychotic disorder is the acute onset of psychotic symptoms after a stressor with short duration and expected full recovery.