The concordance of ICD-10 acute and transient psychosis and DSM-IV brief psychotic disorder

2002 ◽  
Vol 32 (3) ◽  
pp. 525-533 ◽  
Author(s):  
F. PILLMANN ◽  
A. HARING ◽  
S. BALZUWEIT ◽  
R. BLÖINK ◽  
A. MARNEROS
Keyword(s):  
Psychotic Disorder ◽  
Psychotic Disorders ◽  
Good Prognosis ◽  
Acute Onset ◽  
Schizophreniform Disorder ◽  
Not Otherwise Specified ◽  
Brief Psychotic Disorder ◽  
Icd 10 ◽  
Dsm Iv

Background. ICD-10 acute and transient psychotic disorder (ATPD; F23) and DSM-IV brief psychotic disorder (BPD; 298.8) are related diagnostic concepts, but little is known regarding the concordance of the two definitions.Method. During a 5-year period all in-patients with ATPD were identified; DSM-IV diagnoses were also determined. We systematically evaluated demographic and clinical features and carried out follow-up investigations at an average of 2·2 years after the index episode using standardized instruments.Results. Forty-two (4·1%) of 1036 patients treated for psychotic disorders or major affective episode fulfilled the ICD-10 criteria of ATPD. Of these, 61·9% also fulfilled the DSM-IV criteria of brief psychotic disorder; 31·0%, of schizophreniform disorder; 2·4%, of delusional disorder; and 4·8%, of psychotic disorder not otherwise specified. BPD showed significant concordance with the polymorphic subtype of ATPD, and DSM-IV schizophreniform disorder showed significant concordance with the schizophreniform subtype of ATPD. BPD patients had a significantly shorter duration of episode and more acute onset compared with those ATPD patients who did not meet the criteria of BPD (non-BPD). However, the BPD group and the non-BPD group of ATPD were remarkably similar in terms of sociodemography (especially female preponderance), course and outcome, which was rather favourable for both groups.Conclusions. DSM-IV BPD is a psychotic disorder with broad concordance with ATPD as defined by ICD-10. However, the DSM-IV time criteria for BPD may be too narrow. The group of acute psychotic disorders with good prognosis extends beyond the borders of BPD and includes a subgroup of DSM-IV schizophreniform disorder.

scholarly journals Diagnostic validity of ICD-10 acute and transient psychotic disorders and DSM-5 brief psychotic disorder

2017 ◽  
Vol 45 ◽  
pp. 104-113 ◽  
Author(s):  
A.C. Castagnini ◽  
P. Fusar-Poli
Keyword(s):  
Psychotic Disorder ◽  
Psychotic Disorders ◽  
Case Identification ◽  
Migrant Populations ◽  
Diagnostic Categories ◽  
Dsm 5 ◽  
Characteristic Family ◽  
Brief Psychotic Disorder ◽  
Icd 10

AbstractBackground:Short-lived psychotic disorders are currently classified under “acute and transient psychotic disorders” (ATPDs) in ICD-10, and “brief psychotic disorder” (BPD) in DSM-5. This study's aim is to review the literature and address the validity of ATPDs and BPD.Method:Papers published between January 1993 and December 2016 were identified through searches in Web of Science. Reference lists in the located papers provided further sources.Results:A total of 295 articles were found and 100 were included in the review. There were only a few studies about the epidemiology, vulnerability factors, neurobiological correlates and treatment of these disorders, particularly little interest seems to exist in BPD. The available evidence suggests that short-lived psychotic disorders are rare conditions and more often affect women in early to middle adulthood. They also are neither associated with premorbid dysfunctions nor characteristic family predisposition, while there seems to be greater evidence of environmental factors particularly in developing countries and migrant populations. Follow-up studies report a favourable clinical and functional outcome, but case identification has proved difficult owing to high rates of transition mainly either to schizophrenia and related disorders or, to a lesser extent, affective disorders over the short- and longer-terms.Conclusions:Although the lack of neurobiological findings and little predictive power argue against the validity of the above diagnostic categories, it is important that they are kept apart from longer-lasting psychotic disorders both for clinical practice and research. Close overlap between ATPDs and BPD could enhance the understanding of these conditions.

is the Brief Psychotic Disorder a Distinct Nosologic Entity?: A Longitudinal Study of 80 Patients

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
L. Rodriguez Incio ◽  
I. Grande Fullana ◽  
V. Sánchez Gistau ◽  
M. Bernardo Arroyo ◽  
E. Parellada Rodón
Keyword(s):  
Longitudinal Study ◽  
Psychotic Disorder ◽  
Psychotic Disorders ◽  
Psychiatric Inpatient ◽  
Psychotic Episode ◽  
Inpatient Service ◽  
Brief Psychotic Disorder ◽  
Dsm Iv ◽  
Nosologic Entity

Introduction:The DSM-IV-TR category “brief psychotic disorder” includes different concepts that have been defined before like bouffée délirante, cycloid psychosis and “acute and transient psychosis” in the last ICD-10. Limited prospective studies have been done, and they all show a marked diagnostic instability during follow-up. According to that, its independent nosologic entity is still uncertain.Aims:To determine the diagnostic stability of the brief psychotic disorders as well as their distinct clinical features.Method:Observational, retrospective, longitudinal study of 80 consecutive patients admitted at the acute psychiatric inpatient service of a general hospital between 2000 and 2006. at discharge, all of them fulfilled diagnostic criteria for “brief psychotic disorder” according to DSM-IV. Demographic and psychopathological data were analysed.Results:Mean age (SD) was 31.3 (9.5), most of them women (63%). the most frequent previous stressor was related to labour, while up to 45% didn't report any. 51% had no psychiatric family history. 15 (19%) patients previously had a brief psychotic episode. Psychopathological disturbances identified were: thought disorder 69%, anxiety 66.6%, insomnia 57.7%, suspiciousness 53.5%, rapidly changing delusions 53.3% (paranoid contents 75.3%), perplexity 46.5%, auditory hallucinations 45.1%, mood lability 36.6%, elation 23.9%, depressed mood 22.5% and irritability 12.7%. in the 24 month follow-up, 32.5% changed diagnosis to schizophrenia, 3"9% to schizoaffective, 10% to bipolar disorder and 16.9% achieved clinical remission. 28.5% were lost to follow-up.Conclusion:“Brief psychotic disorder” category is still uncertain and more data may be necessary to clarify if it should remain as a distinct nosologic entity.

Antipsychotic polytherapy versus antipsychotic monotherapy in patients with schizophrenia and other psychoses

2011 ◽  
Vol 26 (S2) ◽  
pp. 1265-1265
Author(s):  
N. Morales Alcaide
Keyword(s):  
Combination Therapy ◽  
Psychotic Disorder ◽  
Psychotic Disorders ◽  
Controlled Trials ◽  
Schizophreniform Disorder ◽  
Antipsychotic Therapy ◽  
Not Otherwise Specified ◽  
Brief Psychotic Disorder ◽  
Male Patients ◽  
The Mean

IntroductionAntipsychotic therapy is the cornerstone of the treatment of psychotic disorders. Although clinical guidelines recommend the use of antipsychotics in monotherapy, the combination of two or more antipsychotics is a common habit in clinical practice, especially in cases resistant to treatment with one antipsychotic, although there are few controlled trials that support this treatment modality.ObjectivesTo analyze the characteristics of antipsychotic therapy in patients admitted to hospitalization with diagnoses of schizophrenia and other psychoses, to determine if there are differences between diagnostic groups.MaterialWe analyzed a sample of 241 patients admitted during 2009, 97 women and 144 men, with schizophrenia and other psychoses.MethodsWe designed a protocol of collecting data based on clinical histories of patients, reflecting the gender, age, diagnosis and treatment regimen (monotherapy or combination therapy), and performed a statistical analysis using SPSS.ResultsOf the sample, 40.2% were females and 59.8% were males. The mean age was 39.7 years old.The diagnosis of schizophrenia was obtained in 60.2% of patients, while the remaining 39.8% were diagnosed with other psychoses (schizoaffective disorder, chronic delusional disorder, schizophreniform disorder, brief psychotic disorder, psychotic disorder not otherwise specified and other.)The combination therapy was used in 62.2% of patients, while the remaining 37.8% were treated with monotherapy.ConclusionsCombination therapy is used more often in male patients and in patients diagnosed with schizophrenia, while monotherapy is used more in women and patients with other psychoses.

scholarly journals M97. PREDICTORS OF TRANSITION TO SCHIZOPHRENIA IN BRIEF PSYCHOTIC DISORDER: FINDINGS FROM A 3-YEAR LONGITUDINAL STUDY IN THE PAFIP COHORT

2020 ◽  
Vol 46 (Supplement_1) ◽  
pp. S171-S172
Author(s):  
Álvaro López-Díaz ◽  
Rosa Ayesa-Arriola ◽  
Victor Ortiz-García de la Foz ◽  
Benedicto Crespo-Facorro ◽  
Miguel Ruiz-Veguilla
Keyword(s):  
Logistic Regression ◽  
Mental Disorders ◽  
Psychotic Disorder ◽  
Psychotic Disorders ◽  
Living Alone ◽  
First Episode ◽  
Multivariate Logistic Regression ◽  
Brief Psychotic Disorder ◽  
Dsm Iv

Abstract Background The category ‘brief psychotic disorder’ (BPD) is defined in the Diagnostic and Statistical Manual of Mental Disorders (DSM) as a short-lived psychotic condition in which delusions, hallucinations, disorganised speech or grossly disorganised or catatonic behaviour are present for at least 1 day but less than 1 month. BPD is a relatively uncommon disease accounting for 2–7% of first-episode psychoses (FEP) and it has been poorly investigated in comparison with other psychotic disorders, probably due to its low prevalence and associated good prognosis. However, FEP patients with BPD have low diagnostic stability at follow-up and a high transition rate (around 55%) to long-lasting psychotic disorders, mainly to schizophrenia. This study explored the proportion of diagnostic transition to schizophrenia after 3 years in a cohort of FEP patients with BPD, to determine whether there were early predictive factors for such transition in this BPD population. Methods A 36-month prospective observational study of patients with first-episode BPD was conducted. The sample included subjects aged 18–60 from the intervention programme of first-episode psychosis non-affective psychosis (PAFIP) of the University Hospital Marques de Valdecilla (Spain). BPD diagnoses were confirmed using the Structured Clinical Interview for DSM-IV (SCID-I) at 6 months following admission into the PAFIP programme. Sociodemographic, premorbid and baseline clinical variables were collected and patients were followed over 3 years while they received treatment in the PAFIP programme. A DSM-IV diagnostic reassessment was performed on those patients who completed the follow-up and subjects were classified according to whether or not they had developed schizophrenia after 3 years. Univariate screening was performed to determine variables eligible for the predictive model, and factors that reached statistical or marginal significance (p ≤ 0.1) were selected for multivariate logistic regression analysis. Significant statistical level was set at 0.05. All statistical evaluation was performed using MedCalc Statistical Software (version 19.0.7). Results Of the 569 patients enrolled in the PAFIP programme between 2001 and 2018, 59 met the criteria for BPD. Of those, 40 (67.8%) completed the 36-month follow-up and 16 (40%) maintained their initial BPD diagnosis. Among the patients who developed other mental disorders by the end of the study period (60%; n = 24), the proportion of transition to schizophrenia was 62.5% (n = 15). Being younger at psychosis onset, living alone, a poor premorbid adjustment, acute onset of psychotic symptomatology, and higher severity of hallucinatory behaviour were variables that showed univariate associations with subsequent development of schizophrenia. A multivariate logistic regression model revealed that transition to schizophrenia was independently significantly associated with younger age at psychosis onset (OR = 0.83, 95% CI 0.69–0.99; p = 0.048), living alone (OR = 14.3, 95% CI 1.09–186.77; p = 0.042) and greater hallucinatory activity (OR = 1.81, 95% CI 1.07–3.07; p = 0.028). Discussion Our main findings were that 37.5% of patients who presented an initial BPD diagnosis developed schizophrenia in the following 36 months. Being younger at psychosis onset, living alone and experiencing greater hallucinatory activity at baseline were independent predictors of diagnostic transition to schizophrenia in this BPD population. Individuals with BPD presenting these risk factors should therefore be targeted for intensive interventions similar to those performed on patients with first-episode schizophrenia.

scholarly journals Long term outcomes of acute and transient psychotic disorders: The missed opportunity of preventive interventions

2018 ◽  
Vol 52 ◽  
pp. 126-133 ◽  
Author(s):  
Grazia Rutigliano ◽  
Sergio Merlino ◽  
Amedeo Minichino ◽  
Rashmi Patel ◽  
Cathy Davies ◽  
...  
Keyword(s):  
High Risk ◽  
Psychotic Disorders ◽  
Cumulative Risk ◽  
Acute Onset ◽  
Kaplan Meier ◽  
Schizophrenia Spectrum ◽  
National Health Service Trust ◽  
Icd 10

AbstractBackground:Acute and transient psychotic disorders (ATPD) are characterized by an acute onset and a remitting course, and overlap with subgroups of the clinical high-risk state for psychosis. The long-term course and outcomes of ATPD are not completely clear.Methods:Electronic health record-based retrospective cohort study, including all patients who received a first index diagnosis of ATPD (F23, ICD-10) within the South London and Maudsley (SLaM) National Health Service Trust, between 1 st April 2006 and 15th June 2017. The primary outcome was risk of developing persistent psychotic disorders, defined as the development of any ICD-10 diagnoses of non-organic psychotic disorders. Cumulative risk of psychosis onset was estimated through Kaplan-Meier failure functions (non-competing risks) and Greenwood confidence intervals.Results:A total of 3074 patients receiving a first index diagnosis of ATPD (F23, ICD-10) within SLaM were included. The mean follow-up was 1495 days. After 8-year, 1883 cases (61.26%) retained the index diagnosis of ATPD; the remaining developed psychosis. The cumulative incidence (Kaplan-Meier failure function) of risk of developing any ICD-10 non-organic psychotic disorder was 16.10% at 1-year (95%CI 14.83–17.47%), 28.41% at 2-year (95%CI 26.80–30.09%), 33.96% at 3-year (95% CI 32.25–35.75%), 36.85% at 4-year (95%CI 35.07–38.69%), 40.99% at 5-year (95% CI 39.12–42.92%), 42.58% at 6-year (95%CI 40.67–44.55%), 44.65% at 7-year (95% CI 42.66–46.69%), and 46.25% at 8-year (95% CI 44.17–48.37%). The cumulative risk of schizophrenia-spectrum disorder at 8-year was 36.14% (95% CI 34.09–38.27%).Conclusions:Individuals with ATPD have a very high risk of developing persistent psychotic disorders and may benefit from early detection and preventive treatments to improve their outcomes.

Overview of Schizophrenia and Other Psychotic Disorders

2020 ◽  
Author(s):  
James A. Wilcox ◽  
Donald W. Black
Keyword(s):  
Psychotic Disorder ◽  
Schizoaffective Disorder ◽  
Psychotic Disorders ◽  
Public Health Problem ◽  
Premature Death ◽  
Major Public Health Problem ◽  
Schizophreniform Disorder ◽  
Schizophrenia Spectrum ◽  
Brief Psychotic Disorder ◽  
The Individual

Psychotic disorders are among the most disabling conditions and constitute a major public health problem. Described throughout recorded time, they affect as many as 5% of the population and cause a disproportionate amount of suffering and loss to society. In the chapter on schizophrenia spectrum and other psychotic disorders, the DSM-5 lists delusional disorder, brief psychotic disorder, schizophreniform disorder, schizophrenia, and schizoaffective disorder, as well as categories for substance- or medically induced psychotic disorders. The term psychosis indicates that the individual has a severe inability to interpret the surrounding environment in a realistic way. Symptoms include hallucinations, delusions, and bizarre behavior. Psychotic disorders are associated with premature death, mostly attributable to suicide. The pathophysiology and etiology of psychotic disorders are only now beginning to be understood, and treatment for these conditions remains suboptimal. Researchers are currently refining the cause of these symptoms and developing more effective treatments.   This review contains 3 tables, and 34 references. Key words: Brief psychotic disorder, delusions, hallucinations, psychosis, schizoaffective disorder, schizophrenia, schizophreniform disorder

scholarly journals Acute and transient psychoses: clinical and nosological issues

2016 ◽  
Vol 22 (5) ◽  
pp. 292-300 ◽  
Author(s):  
Augusto Castagnini ◽  
Gian Maria Galeazzi
Keyword(s):  
Psychotic Disorder ◽  
Psychotic Disorders ◽  
Diagnosis And Treatment ◽  
Cycloid Psychosis ◽  
Dsm 5 ◽  
Brief Psychotic Disorder ◽  
Icd 10

SummaryThis article examines the clinical, epidemiological and nosological aspects of short-lived psychotic disorders as currently classified under ‘acute and transient psychotic disorders' in ICD-10 and ‘brief psychotic disorder’ in DSM-5. After describing earlier diagnostic concepts such as bouffée délirante, cycloid psychosis, reactive psychosis and schizophreniform psychosis, we present an overview of the literature and discuss implications for classification, diagnosis and treatment of these conditions, pointing out differences from longer-lasting psychotic disorders.

Brief psychotic disorder with delusion content related to the COVID-19 outbreak

Psychiatriki ◽  
2021 ◽  
Author(s):  
Kyriaki Marouda ◽  
Leonidas Mantonakis ◽  
Konstantinos Kollias
Keyword(s):  
Case Report ◽  
Psychotic Disorder ◽  
Psychiatric Symptoms ◽  
Stressful Life Event ◽  
Psychological Impact ◽  
Strong Relationship ◽  
Brief Psychotic Disorder ◽  
Icd 10 ◽  
History Of

The COVID-19 outbreak has affected millions of people globally and it also has a huge psychological impact. The objective of this case report is to outline the possible effect of the COVID-19 pandemic to the content of delusions in patients with psychosis. Α 34-year-old male with no history of mental disorder, involuntarily hospitalized due to agitation and aggression towards others, experienced grandiose delusions, referential delusions and delusions of passivity. The content of all his delusions was related to the COVID-19 pandemic. His symptoms were not proven to be caused by any physical condition or substance use disorder. He was prescribed olanzapine 10mg bd and lorazepam 2,5mg td and demonstrated significant improvement with a complete subsidence of his symptoms within a week. He was discharged after a total of 13 days with an ICD-10 diagnosis of brief psychotic disorder. At his 6 months follow-up, he reported no psychiatric symptoms. Existing literature indicates a strong relationship between life experiences and the content of delusions. This case report highlights how the stressful life event of the COVID-19 outbreak affected the content of our patient’s delusions.

Overview of Schizophrenia and Other Psychotic Disorders

2020 ◽  
Author(s):  
James A. Wilcox ◽  
Donald W. Black
Keyword(s):  
Psychotic Disorder ◽  
Schizoaffective Disorder ◽  
Psychotic Disorders ◽  
Public Health Problem ◽  
Premature Death ◽  
Major Public Health Problem ◽  
Schizophreniform Disorder ◽  
Schizophrenia Spectrum ◽  
Brief Psychotic Disorder ◽  
The Individual

Psychotic disorders are among the most disabling conditions and constitute a major public health problem. Described throughout recorded time, they affect as many as 5% of the population and cause a disproportionate amount of suffering and loss to society. In the chapter on schizophrenia spectrum and other psychotic disorders, the DSM-5 lists delusional disorder, brief psychotic disorder, schizophreniform disorder, schizophrenia, and schizoaffective disorder, as well as categories for substance- or medically induced psychotic disorders. The term psychosis indicates that the individual has a severe inability to interpret the surrounding environment in a realistic way. Symptoms include hallucinations, delusions, and bizarre behavior. Psychotic disorders are associated with premature death, mostly attributable to suicide. The pathophysiology and etiology of psychotic disorders are only now beginning to be understood, and treatment for these conditions remains suboptimal. Researchers are currently refining the cause of these symptoms and developing more effective treatments.   This review contains 3 tables, and 34 references. Key words: Brief psychotic disorder, delusions, hallucinations, psychosis, schizoaffective disorder, schizophrenia, schizophreniform disorder

Long-term course of acute brief psychosis in a developing country setting

1998 ◽  
Vol 173 (3) ◽  
pp. 226-230 ◽  
Author(s):  
Ezra Susser ◽  
Vijoy K. Varma ◽  
S. K. Mattoo ◽  
Molly Finnerty ◽  
Ramin Mojtabai ◽  
...  
Keyword(s):  
Developing Country ◽  
Psychotic Disorders ◽  
Comparison Group ◽  
Acute Onset ◽  
North India ◽  
Separable Group ◽  
Early Relapse ◽  
Icd 10

BackgroundThis study in North India compared acute brief psychosis – defined by acute onset, brief duration and no early relapse – with other remitting psychoses, over a 12-year course and outcome.MethodIn a cohort of incident psychoses, we identified 20 cases of acute brief psychosis and a comparison group of 43 other remitting psychoses based on two-year follow-up. Seventeen people (85%) in the acute brief psychosis group and 36 (84%) in the comparison group were reassessed at five, seven and 12 years after onset, and were rediagnosed using ICD–10 criteria.ResultsAt 12-year follow-up, the proportion with remaining signs of illness was 6% (n=1) for acute brief psychosis versus 50% (n=18) for the comparison group (P=0.002). Using ICD–10 criteria, the majority in both groups were diagnosed as having schizophrenia.ConclusionsAcute brief psychosis has a distinctive and benign long-term course when compared with other remitting psychoses. This finding supports the ICD– 10 concept of a separable group of acute and transient psychotic disorders. To effectively separate this group, however, the ICD–10 criteria need modification.

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