Clinical manifestations in patients with acute and transient psychosis

IntroductionThe term, acute and transient psychosis, is comprehended as a heterogeneous group of disorders, which share, as a common feature, the abrupt and brief deployment of typical psychotic behaviour, either polymorph, delusional, or schizophreniform. This diversity of symptoms may also be present in other psychotic disorders, for which, some authors question its reliability.ObjetiveTo analyse the clinical manifestations present in acute and transient psychotic disorders (ATPD), and determine the differences between its different subcategories.MethodRetrospective chart review study of adult patients admitted in our psychiatric unit between 2011 and 2015, with a mean diagnosis of ATPD at hospital discharge. Diagnostic criteria was according to the International Classification of Diseases (ICD-10). Symptoms were divided under operative procedures, as set out in psychopatologic descriptions. For methodological reasons, statistical analysis was conducted between polymorphic features group (PM) and nonpolymorphic group (NPM). Chi-squared test and Fisher's exact test (as appropriate) were performed, using MedCalc software.ResultsThirty-nine patients met the inclusion criteria. Acute polymorphic psychotic disorder with and without symptoms of schizophrenia (39%), acute schizophrenia-like psychotic disorder (20%), acute predominantly delusional psychotic disorder (23%), other and NOS (18%). There were statistically significant differences between PM and NPM groups in emotional turmoil (>PM, P = 0.0006), grossly disorganized or abnormal motor behaviour (>PM, P = 0.0038), and type of onset (sudden >PM, P = 0.0145).ConclusionCurrently, the same concept encompasses two categories (PM and NPM) to be differentiated. The ATPD construct is under review, due its long-term instability.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Download Full-text

A case of acute and transient psychosis–What to expect?

European Psychiatry ◽

10.1016/j.eurpsy.2016.01.1306 ◽

2016 ◽

Vol 33 (S1) ◽

pp. S364-S365

Author(s):

M. Oliveira ◽

J. Rebelo ◽

A.S. Costa ◽

C. Santos

Keyword(s):

Psychotic Disorders ◽

Fast Response ◽

International Classification Of Diseases ◽

Acute Onset ◽

Antipsychotic Treatment ◽

Duration Of Treatment ◽

Diagnostic Stability ◽

Affective Symptoms ◽

Classification Of Diseases ◽

Competing Interest

IntroductionThe Tenth Revision of the International Classification of Diseases (ICD-10) introduced the category of Acute and transient psychotic disorders (ATPD), that assimilate clinical concepts such as the French Bouffée Délirante, Kleist and Leonhard's cycloid psychosis, and the scandinavian reactive psychosis.Methods and aimsThe authors present a clinical case of ATPD and a literature review based on PubMed/MEDLINE, using the keywords: “acute and transient psychotic disorder”, “prognosis” and “diagnostic stability”, aiming to discuss the main challenges regarding the diagnosis, treatment and prognosis.ResultsThe patient is a male with 37 years old with two previous psychotic episodes (with 2.5 years of interval), both with an acute onset (of 7 and 3 days respectively), and a fast response to antipsychotic treatment, with periods of complete symptom's remission. He maintains treatment with 6 mg of paliperidone. In the literature, we found scarce information on ATPD. Though several variables have been described as having influence on the prognosis (gender, pre-morbid functioning, acute onset and presence of affective symptoms), this topic remains controversial. Another difficult aspect about ATPD seems to be its low diagnostic stability, with diagnosis changing mostly to Schizophrenia, Schizoaffective disorder and Bipolar disorder. Duration of treatment after complete remission of symptoms is another controversial aspect of this disease.ConclusionsATPD seems to have low diagnostic stability and poor research investment, and so it represents a challenge for psychiatrists on managing these patients in terms of treatment and follow-up plan. Further studies should be held regarding prognosis and treatment.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Download Full-text

Study of psychiatric disorders among nepalese patients working abroad and their family members

Journal of College of Medical Sciences-Nepal ◽

10.3126/jcmsn.v6i4.6718 ◽

2012 ◽

Vol 6 (4) ◽

pp. 1-6

Author(s):

B Yengkokpam ◽

SK Shah ◽

GR Bhantana

Keyword(s):

Psychiatric Disorders ◽

Psychotic Disorders ◽

Somatoform Disorders ◽

Bipolar Affective Disorder ◽

Family Members ◽

International Classification Of Diseases ◽

Obsessive Compulsive ◽

Compulsive Disorder ◽

Classification Of Diseases ◽

Icd 10

This study was carried out among the patients working abroad and their family members, having various psychiatric disorders. 80 patients attending psychiatry OPD between the age of 15 to 65 years both male and female in the period of July 2009 to July 2010 were included. The results were tabulated as per the diagnostic criteria of International Classification of Diseases (ICD-10). Out of total 80 patients, 41 were males and 39 were females, whose husbands were working abroad. 30 cases were of depression,out of which 16 were males and 14 were females.18 cases were having anxiety disorders out of which 5 were males and 13 were females. 12 cases were suffering from psychotic disorders out of which 10 were males and 2 were females.7 cases were having dissociative disorders with 1 male and 6 females.4 cases were having somatoform disorders with 2 males and 2 females.1 male and 1 female were suffering from mania.1 male and 1 female were suffering from bipolar affective disorder. 2 males were alcohol dependent and 2 males were having obsessive compulsive disorder. 1 male was having organic psychosis. Journal of College of Medical Sciences-Nepal,2011,Vol-6,No-4, 1-6 DOI: http://dx.doi.org/10.3126/jcmsn.v6i4.6718

Download Full-text

Risk of dementia associated with psychotic disorders in later life: the health in men study (HIMS)

Psychological Medicine ◽

10.1017/s003329171800065x ◽

2018 ◽

Vol 49 (2) ◽

pp. 232-242 ◽

Cited By ~ 5

Author(s):

Osvaldo P. Almeida ◽

Andrew H. Ford ◽

Graeme J. Hankey ◽

Bu B. Yeap ◽

Jonathan Golledge ◽

...

Keyword(s):

Psychotic Disorder ◽

Psychotic Disorders ◽

Age Of Onset ◽

Bipolar Disorders ◽

Later Life ◽

International Classification Of Diseases ◽

Renal Diseases ◽

Increased Risk ◽

Clinical Diagnoses ◽

Classification Of Diseases

AbstractBackgroundRecent research has identified several potentially modifiable risk factors for dementia, including mental disorders. Psychotic disorders, such as schizophrenia and delusional disorder, have also been associated with increased risk of cognitive impairment and dementia, but currently available data difficult to generalise because of bias and confounding. We designed the present study to investigate if the presence of a psychotic disorder increased the risk of incident dementia in later life.MethodsProspective cohort study of a community-representative sample of 37 770 men aged 65–85 years who were free of dementia at study entry. They were followed for up to 17.7 years using electronic health records. Clinical diagnoses followed the International Classification of Diseases guidelines. As psychotic disorders increase mortality, we considered death a competing risk.ResultsA total of 8068 (21.4%) men developed dementia and 23 999 (63.5%) died during follow up. The sub-hazard ratio of dementia associated with a psychotic disorder was 2.67 (95% CI 2.30–3.09), after statistical adjustments for age and prevalent cardiovascular, respiratory, gastrointestinal and renal diseases, cancer, as well as hearing loss, depressive and bipolar disorders, and alcohol use disorder. The association between psychotic disorder and dementia risk varied slightly according to the duration of the psychotic disorder (highest for those with the shortest illness duration), but not the age of onset. No information about the use of antipsychotics was available.ConclusionOlder men with a psychotic disorder have nearly three times greater risk of developing dementia than those without psychosis. The pathways linking psychotic disorders to dementia remain unclear but may involve mechanisms other than those associated with Alzheimer's disease and other common dementia syndromes.

Download Full-text

Diagnostic Stability of Acute and Transient Psychotic Disorders in Patients Attending Tertiary Care Hospital

Journal of Universal College of Medical Sciences ◽

10.3126/jucms.v2i4.12035 ◽

2015 ◽

Vol 2 (4) ◽

pp. 7-10 ◽

Cited By ~ 1

Author(s):

Sanjeev Ranjan ◽

R Shakya ◽

P M Shyangwa

Keyword(s):

Mood Disorders ◽

Psychotic Disorders ◽

Tertiary Care ◽

International Classification Of Diseases ◽

Health Science ◽

Care Hospital ◽

Medical Sciences ◽

Diagnostic Stability ◽

Classification Of Diseases ◽

Icd 10

INTRODUCTION: Acute and Transient Psychotic Disorders (ATPDs) have been the subject of nosological debate. Some authors argue that these conditions should be considered as an independent group of disorders. Others view these psychoses as variants of schizophrenia or mood disorders, pointing to their diagnostic instability. There have been few studies of the diagnostic stability based on the International Classification of Diseases-tenth edition (ICD-10) category of ATPDs, and these studies have mixed results. This study was done to examine the diagnostic stability of ATPDs according to ICD-10. MATERIAL AND METHODS: Thirty patients diagnosed as ATPDs at psychiatry department of B.P. Koirala Institute of Health Science (BPKIHS) were followed up at one month and after three months of their onset of illness. Their diagnosis was reassessed at every follow-up using standard instrument. RESULTS: The diagnosis of ATPDs was unchanged in twenty four (80%) out of thirty patients. Diagnostic change was to schizophrenia in three cases and to mood disorders in three other cases. CONCLUSION: Overall, ATPDs is a diagnostically stable entity.DOI: http://dx.doi.org/10.3126/jucms.v2i4.12035Journal of Universal College of Medical Sciences (2014) Vol.02 No.04 Issue 08,Page: 7-10

Download Full-text

Diagnostic stability of acute and transient psychotic disorders in developing country settings: an overview

Mental Illness ◽

10.1108/mi.2015.5640 ◽

2015 ◽

Vol 7 (1) ◽

pp. 13-15

Author(s):

Shubham Mehta

Keyword(s):

Developing Countries ◽

Developing Country ◽

Psychotic Disorders ◽

Diagnostic System ◽

International Classification Of Diseases ◽

Abrupt Onset ◽

Diagnostic Stability ◽

Classification Of Diseases ◽

Icd 10 ◽

Pubmed Search

Acute and transient psychotic disorders (ATPD), introduced in the International Classification of Diseases (ICD-10) diagnostic system in 1992, are not receiving much attention in developing countries. Therefore, the main objective of this article is to review the literature related to the diagnostic stability of ATPD in developing countries. A PubMed search was conducted to review the studies concerned with this issue in the context of developing countries, as diagnostic stability is more of a direct test of validity of psychiatric diagnoses. Four publications were found. According to the literature search, the stability percentage of the ICD-10 ATPD diagnosis is 63-100%. The diagnostic shift is more commonly either towards bipolar disorder or schizophrenia, if any. Shorter duration of illness (<1 month) and abrupt onset (<48 hours) predict a stable diagnosis of ATPD. Based on available evidence, the diagnosis of ATPD appears to be relatively stable in developing countries. However, it is difficult to make a definitive conclusion, as there is a substantial lack of literature in developing country settings.

Download Full-text

Diagnostic stability of acute and transient psychotic disorders in developing country settings: an overview

Mental Illness ◽

10.4081/mi.2015.5640 ◽

2015 ◽

Vol 7 (1) ◽

Author(s):

Shubham Mehta

Keyword(s):

Developing Countries ◽

Developing Country ◽

Psychotic Disorders ◽

Diagnostic System ◽

International Classification Of Diseases ◽

Abrupt Onset ◽

Diagnostic Stability ◽

Classification Of Diseases ◽

Icd 10 ◽

Pubmed Search

Download Full-text

CLASSIFICATION AND DIAGNOSIS OF SCHIZOPHRENIA OR OTHER PRIMARY PSYCHOTIC DISORDERS: CHANGES FROM ICD-10 TO ICD-11 AND IMPLEMENTATION IN CLINICAL PRACTICE

10.31219/osf.io/zv79p ◽

2020 ◽

Author(s):

Wolfgang Gaebel ◽

Ariane Kerst ◽

Johannes Stricker

Keyword(s):

Clinical Practice ◽

Psychotic Disorders ◽

Stakeholder Involvement ◽

Field Studies ◽

International Classification Of Diseases ◽

Mortality And Morbidity ◽

Critical Elements ◽

Classification Of Diseases ◽

Icd 10

From January 2022, the WHO member countries shall start implementing the mortality and morbidity statistics (MMS) version of the eleventh revision of the International Classification of Diseases (ICD-11). Regarding mental, behavioural or neurodevelopmental disorders, there are substantial changes from ICD-10 to ICD-11. The subchapter for schizophrenia or other primary psychotic disorders has changed due to a revised structure, new diagnostic criteria, and the introduction of dimensional elements (i.e., course and symptom qualifiers). The aim of this manuscript is twofold. First, we review changes from ICD-10 to ICD- 11 in the classification and diagnosis of schizophrenia or other primary psychotic disorders, including findings from recent field studies. Second, we provide an overview of approaches to the implementation of ICD-11 in clinical practice. Critical elements for transition from ICD-10 to ICD 11 include the use of digital tools, education and training, stakeholder involvement, national adaptations, and continuous evaluation.

Download Full-text

Changes needed in the classification of anxiety disorders in childhood: Options for ICD-11

Srpski arhiv za celokupno lekarstvo ◽

10.2298/sarh1506369s ◽

2015 ◽

Vol 143 (5-6) ◽

pp. 369-372

Author(s):

Miodrag Stankovic ◽

Grozdanko Grbesa ◽

Jelena Kostic ◽

Sandra Stankovic ◽

Jelena Stevanovic

Keyword(s):

Anxiety Disorders ◽

Emotional Disorders ◽

Clinical Picture ◽

Clinical Manifestations ◽

International Classification Of Diseases ◽

Phobic Disorders ◽

Classification Of Diseases ◽

Icd 10 ◽

Separate Block

Considering the intensive preparation of the 11th revision of the International Classification of Diseases (ICD-11), we discussed the justification of the existing classification of emotional disorders with onset specific to childhood. This paper presents the citations from the ICD-10 (F93 block) and the authors? comments as a critical review of the justification of further existence of emotional disorders with onset specific to childhood as a separate block in ICD-11 classification. We concluded that the block F93 is insufficiently defined and should be completely changed or removed from the ICD-11 classification. Additionally, the specificities of the clinical picture of anxiety disorders in children should be adequately described within the future category of anxiety and phobic disorders by giving an explicit set of instructions for identifying clinical manifestations which vary by age.

Download Full-text

What’s Happened to Paraphrenia? The Modernity of Emil Kraepelin’s Thinking

European Psychiatry ◽

10.1016/s0924-9338(09)71417-8 ◽

2009 ◽

Vol 24 (S1) ◽

pp. 1-1

Author(s):

L. Pelizza ◽

F. Bonazzi

Keyword(s):

Psychotic Disorders ◽

Diagnostic Category ◽

International Classification Of Diseases ◽

Delusional Disorder ◽

Systematic Research ◽

Diagnostic And Statistical Manual ◽

Classification Of Diseases ◽

Icd 10 ◽

Dsm Iv

Paraphrenia is a psychotic disorder described by Kraepelin in 1913. He formulated this concept to define a group of patients who exhibited symptoms characteristic of dementia praecox (marked delusions with or without hallucinations), but with minimal disturbances of emotion and volition, and much less personality deterioration. after the publication of Mayer"s prognostic research in 1921 (which studied the outcomes of 78 paraphrenic patients reported by Kraepelin), the view to differentiate paraphrenia from schizophrenia was considered to be unfounded in Germany. Paraphrenia is now diagnosed relatively infrequently and is not listed in the current Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) or International Classification of Diseases (ICD-10). However, it appears that some psychiatrists recognize the illness but label it "atypical psychosis", "schizoaffective disorder," or "delusional disorder" for lack of a better diagnostic category.Virtually no systematic research on paraphrenia has been conducted in the past 60 years. We describe a 30-year-old man affected by sistematic paraphrenia, according to the neo-Kraepelinian description of paraphrenia proposed by Ravindran et al. in 1999 (description compatible with the formats of DSM-IV and ICD-10). Using a questionnaire adapted from this description, our case of paraphrenia were distinguished from those of schizophrenia and delusional disorder. in conclusion, It is possible to define and recognize paraphrenia, because it is a viable diagnostic entity. as in the days of Kraepelin, the problems concerning paraphrenia cannot be neglected when considering the classification of psychotic disorders.

Download Full-text

Diagnostic Stability in Patients with First-Episode Psychosis

Australasian Psychiatry ◽

10.1080/j.1440-1665.2005.02199.x ◽

2005 ◽

Vol 13 (4) ◽

pp. 388-392 ◽

Cited By ~ 25

Author(s):

Homayoun Amini ◽

Javad Alaghband-Rad ◽

Abbas Omid ◽

Vandad Sharifi ◽

Rozita Davari-Ashtiani ◽

...

Keyword(s):

Psychotic Disorders ◽

International Classification Of Diseases ◽

First Episode Psychosis ◽

Classification Systems ◽

First Episode ◽

Episode Psychosis ◽

Classification Of Diseases ◽

Icd 10 ◽

Dsm Iv

Objective: To examine the short-term stability of Diagnostic and Statistical Manual of Mental Disorders (4th edn; DSM-IV) and International Classification of Diseases (10th revision; ICD-10) diagnoses in a group of patients with first-episode psychosis. Method: Sixty patients with first-episode psychosis admitted consecutively to Roozbeh Hospital, Tehran, were sampled; their illnesses could not be attributed to any medical or substance-induced conditions. Patients were assessed at the time of discharge from the hospital, and at 3, 6and 12 month intervals following admission. Ateach visit, two psychiatrists made consensusDSM-IV and ICD10 diagnoses, based on all available information. Stability was discerned as the consistency between diagnoses at the time of discharge and at 12 month follow up. Results: Forty-eight patients completed follow up. Affective psychotic disorders and schizophrenia in both classification systems were highly stable. In addition, all patients with DSM-IV brief psychotic disorder and ICD-10 acute and transient psychotic disorders remained the same at follow up. Conclusions: Affective psychoses and schizophrenia, in line with previous findings, remained stable. Diagnoses of brief psychoses were highly stable as well; this could reflect a non-relapsing course ofacute brief psychoses, especially in developing countries.

Download Full-text