Delineation of Acute and Transient Psychotic Disorders in a Developing Country Setting

1995 ◽  
Vol 167 (2) ◽  
pp. 216-219 ◽  
Author(s):  
Ezra Susser ◽  
Vijoy K. Varma ◽  
Savita Malhotra ◽  
Sarah Conover ◽  
Xavier F. Amador
Keyword(s):  
Developing Country ◽  
Affective Disorders ◽  
Psychotic Disorders ◽  
Acute Psychosis ◽  
Affective Psychosis ◽  
Affective Symptoms ◽  
Long Duration ◽  
Icd 10

BackgroundWe examined whether acute transient psychoses can be distinguished from schizophrenia and the affective disorders.MethodWe studied 46 cases of nonaffective acute psychosis in the Chandigarh Acute Psychosis Study. With respect to separation from schizophrenia, we examined the distribution of duration of the episode. With respect to separation from affective disorders, we assessed the frequency of affective symptoms.ResultsDuration was bimodal, suggesting the presence of two distinct conditions of short and long duration. Affective symptoms were minimal, suggesting that these were not atypical affective syndromes.ConclusionsAcute transient psychoses conform neither with schizophrenia of brief duration nor with atypical affective psychosis, and thus require separate classification as proposed in the ICD–10.

Family psychiatric morbidity of acute and transient psychotic disorders and their relationship to schizophrenia and bipolar disorder

2013 ◽  
Vol 43 (11) ◽  
pp. 2369-2375 ◽  
Author(s):  
A. C. Castagnini ◽  
T. M. Laursen ◽  
P. B. Mortensen ◽  
A. Bertelsen
Keyword(s):  
Bipolar Disorder ◽  
Affective Disorders ◽  
Rate Ratio ◽  
Psychotic Disorders ◽  
Incidence Rate Ratio ◽  
Psychiatric Morbidity ◽  
Additional Risk ◽  
Distinctive Features ◽  
The Family ◽  
Icd 10

BackgroundAlthough transient psychotic disorders are currently classified as a category separate from schizophrenia (SZ) and affective disorders, their distinctive features remain uncertain. This study examines the family psychiatric morbidity of the ICD-10 category of ‘acute and transient psychotic disorders’ (ATPDs), pointing out differences from SZ and bipolar disorder (BD).MethodFrom a cohort of 2.5 million persons, we identified all patients enrolled in the Danish Psychiatric Register who were ever admitted with ATPDs (n=2537), SZ (n = 10639) and BD disorder (n=5292) between 1996 and 2008. The relative risk (RR) of ATPDs, SZ and BD associated with psychiatric morbidity in first-degree relatives (FDRs) was calculated as the incidence rate ratio using Poisson regression.ResultsThe RR of ATPDs [1.93, 95% confidence interval (CI) 1.76–2.11] was higher if patients with ATPDs had at least one FDR admitted with any mental disorder than patients without family psychiatric antecedents. An additional risk arose if they had FDRs admitted not only with ATPDs (RR 1.60, 95% CI 1.33–1.92) but also with SZ (RR 2.06, 95% CI 1.70–2.50) and/or BD (RR 1.55, 95% CI 1.23–1.96). Despite some overlap, the risk of SZ (RR 2.80, 95% CI 2.58–3.04) and BD (RR 3.68, 95% CI 3.29–4.12) was markedly higher if patients with SZ and BD had FDRs admitted with the same condition.ConclusionsThese findings suggest that family psychiatric predisposition has a relatively modest impact on ATPDs and argue against a sharp differentiation of ATPDs from SZ and BD.

scholarly journals Acute and transient psychotic disorders: precursors, epidemiology, course and outcome

2004 ◽  
Vol 185 (6) ◽  
pp. 452-459 ◽  
Author(s):  
Swaran P. Singh ◽  
Tom Burns ◽  
Shazad Amin ◽  
Peter B. Jones ◽  
Glynn Harrison
Keyword(s):  
Psychotic Disorders ◽  
First Episode Psychosis ◽  
Acute Onset ◽  
Favourable Outcome ◽  
First Episode ◽  
Affective Psychosis ◽  
Episode Psychosis ◽  
Icd 10 ◽  
Premorbid Functioning ◽  
Better Than

BackgroundICD–10 has introduced the diagnostic group acute and transient psychotic disorders (ATPDs; F23). Aims To validate the nosological distinctiveness of ICD–10 ATPDs by following up an inception cohort with first-episode psychosis. Method All patients with first-episode psychosis identified in Nottingham between 1992 and 1994 and diagnosed using ICD–10 criteria were reassessed 3 years later. ATPD outcomes were compared with schizophrenia and affective psychosis. Multivariate analyses were conducted to determine whether acute onset and early remission predicted favourable 3-year outcome in first-episode psychosis. Results Of 168 cases of first-episode psychosis, 32 (19%) received an intake diagnosis of ATPD. The diagnosis of ATPD was stable in women over 3 years, but not in men. Outcomes in ATPD were better than in schizophrenia and similar to affective psychosis. In non-affective psychoses, favourable outcomes were a function of gender and premorbid functioning rather than acute onset and early remission. Conclusions The ICD–10 criteria for ATPDs identify a diagnostically unstable group of disorders. Acute onset and early remission do not independently predict favourable outcome over 3 years in first-episode psychosis.

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.

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

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.

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

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

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 (&lt;1 month) and abrupt onset (&lt;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.

Pharmacotherapy of acute psychotic states: The reason for benzodiazepines and valproic acid augmentation

2016 ◽  
Vol 33 (S1) ◽  
pp. S612-S612
Author(s):  
A. Veraksa ◽  
A. Egorov
Keyword(s):  
Valproic Acid ◽  
Mental Disorders ◽  
Mental State ◽  
Schizoaffective Disorder ◽  
Affective Disorders ◽  
Psychotic Disorders ◽  
Bipolar Affective Disorder ◽  
Schizophrenia Spectrum ◽  
Icd 10 ◽  
Competing Interest

Acute psychotic states (APS) usually are diagnosed as schizophrenia spectrum and affective disorders and make up about 45% of cases. The goal of the study was to elucidate the effect of benzodiazepines (BDZ) and valproic acid augmentation in the APS pharmacotherapy. The study was carried out on 102 inpatients diagnosed up to ICD-10 as schizophrenia (n = 24), acute and transient psychotic disorders (n = 40), other mental disorders due to brain damage and dysfunction and to physical disease (n = 17), schizoaffective disorder (n = 12), bipolar affective disorder (n = 9). Patients were randomized into four therapeutic groups:– benzodiazepines (BDZ);– one neuroleptic or combination of one neuroleptic and one BDZ (NBDZ);– combination of valproic acid with BDZ or neuroleptic (VBDZN);– polypragmasy (PP): from two drugs of one group up to four and more drugs at the same time.The mental state of the patients was evaluated daily and estimated before, weekly and after APS termination by BPRS and CGI scale. The APS in all groups lasted from 1 to 50 days (mean 11.4). The shortest duration of APS was In BDZ group – 4.7 days; in VBDZN and NBDZ, the duration was 7.0 and 7.4 days (P < 0.05); in PP group, the treatment lasted 24.5 days (P < 0.001). Before therapy, average BPRS rate was 43.5 ± 8.1, CGI – 6.2 ± 0.8; after APS, BPRS was 18.9 ± 2.1, CGI – 1.1 ± 0.3. All rates did not differ among subgroups. APS therapy by BDZ and its combination with neuroleptics and valproic acid was effective compared to the polypragmasy.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Cycloid psychosis: a clinical and nosological study

2003 ◽  
Vol 33 (3) ◽  
pp. 443-453 ◽  
Author(s):  
VICTOR PERALTA ◽  
MANUEL J. CUESTA
Keyword(s):  
Mood Disorders ◽  
Discriminant Validity ◽  
Psychotic Disorders ◽  
Diagnostic Systems ◽  
Cycloid Psychosis ◽  
Affective Symptoms ◽  
Icd 10 ◽  
Dsm Iv ◽  
Morbidity Risk ◽  
First Rank Symptoms

Background. Despite its clinical relevance, the diagnosis of cycloid psychosis has been relatively neglected in the psychiatric literature and in the current nosological systems. This study examined the clinical validity and nosological status of the cycloid psychosis concept.Method. Six-hundred and sixty psychotic in-patients were assessed for psychosis-related variables and diagnosed according to DSM-III-R, DSM-IV, ICD-10 and the Perris & Brockington criteria for cycloid psychosis. The cycloid psychosis diagnosis (N=68, 10·3%) was examined in regard to its discriminant validity, concordance with other psychotic disorders, and predictive validity in relation to schizophrenia and psychotic mood disorders. To address putative heterogeneity within cycloid psychosis, affective (N=38) and non-affective (N=30) subgroups were examined.Results. Cycloid psychosis had good discriminant validity regarding other psychoses (95% of correctly classified cases) and poor concordance with individual diagnoses from the formal diagnostic systems (κ<0·22). Cycloid patients had levels of psychotic, disorganization and first-rank symptoms comparable to schizophrenia, and levels of affective symptoms in-between schizophrenia and mood disorders. Regarding most clinical variables and morbidity risk of mood disorders, cycloid psychosis was closer to mood disorders. Cycloid psychosis had higher psychosocial stressors than schizophrenia and mood disorders. Affective and non-affective groups of cycloid psychosis differed in a number of variables indicating an overall better outcome for the non-affective group.Conclusions. Cycloid psychosis does not correspond closely to any DSM-III-R, DSM-IV or ICD-10 category of psychosis, and more specifically this nosological concept is not well represented by the different formal definitions of remitting psychotic disorders. Cycloid psychosis seems to be an heterogeneous condition in that affective and non-affective subgroups can be differentiated.

scholarly journals National record-linkage study of hospital admissions for schizophrenia in childhood and adolescence in England

2021 ◽  
Author(s):  
Olena Seminog ◽  
Uy Hoang ◽  
Michael Goldacre ◽  
Anthony James
Keyword(s):  
Hospital Admissions ◽  
Population Based ◽  
Linkage Study ◽  
Incidence Rates ◽  
Childhood And Adolescence ◽  
Childhood Onset ◽  
Affective Psychosis ◽  
Health Service Provision ◽  
Childhood Onset Schizophrenia ◽  
Icd 10

Abstract Background There is a lack of information on changes in hospital admission rates for childhood-onset schizophrenia (COS), or on patient characteristics, to inform clinical research and health service provision. Aims To report age- and sex-specific incidence rates of hospital admissions and day patient care for schizophrenia (ICD-10 F20) and non-affective psychosis (ICD-10 F20-29), by year of occurrence and age, in childhood and adolescence. Methods Population-based study using person-linked data for England (available 2001–2016); time-periods in single years and 4-year groups. Results Hospitalised incidence for schizophrenia increased with increasing age, from 0.03 (95% confidence interval (CI) 0.02–0.05) and 0.01 (0–0.01) per 100,000 in, respectively, males and females aged 5–12 years, to 3.67 (3.44–3.91) in males and 1.58 (1.43–1.75) in females aged 13–17 years. There was no gender difference in hospitalised incidence rates in children aged 5–12, but in 13–17 years old, there was a male excess. Rates for schizophrenia were stable over time in 5–12 years old. In ages 13–17, rates for schizophrenia decreased between 2001–2004 and 2013–2016 in males, from 6.65 (6.04–7.31) down to 1.40 (1.13–1.73), and in females from 2.42 (2.05–2.83) to 1.18 (0.92–1.48). The hospitalisation rates for schizophrenia and non-affective psychosis, combined, in 13–17 years old decreased in males from 14.20 (13.30–15.14) in 2001–2004 to 10.77 (9.97–11.60) in 2013–2016, but increased in females from 7.49 (6.83–8.20) to 10.16 (9.38–11.00). Conclusions The study confirms that childhood-onset schizophrenia is extremely rare, with only 32 cases identified over a 15-year period in the whole of England. The incidence of schizophrenia and non-affective psychosis increased substantially in adolescence; however, the marked reduction in the proportion of those diagnosed with schizophrenia in this age group suggests a possible change in diagnostic practice.

scholarly journals Adolescent cannabis use, baseline prodromal symptoms and the risk of psychosis

2018 ◽  
Vol 212 (4) ◽  
pp. 227-233 ◽  
Author(s):  
Antti Mustonen ◽  
Solja Niemelä ◽  
Tanja Nordström ◽  
Graham K. Murray ◽  
Pirjo Mäki ◽  
...  
Keyword(s):  
Substance Use ◽  
General Population ◽  
Birth Cohort ◽  
Psychotic Disorders ◽  
Temporal Order ◽  
Population Based ◽  
Cannabis Use ◽  
Prodromal Symptoms ◽  
Increased Risk ◽  
Icd 10

BackgroundThe association between cannabis use and the risk of psychosis has been studied extensively but the temporal order still remains controversial.AimsTo examine the association between cannabis use in adolescence and the risk of psychosis after adjustment for prodromal symptoms and other potential confounders.MethodThe sample (n = 6534) was composed of the prospective general population-based Northern Finland Birth Cohort of 1986. Information on prodromal symptoms of psychosis and cannabis use was collected using questionnaires at age 15–16 years. Participants were followed up for ICD-10 psychotic disorders until age 30 years using nationwide registers.ResultsThe risk of psychosis was elevated in individuals who had tried cannabis five times or more (hazard ratio, (HR) = 6.5, 95% CI 3.0–13.9). The association remained statistically significant even when adjusted for prodromal symptoms, other substance use and parental psychosis (HR = 3.0, 95% CI 1.1–8.0).ConclusionsAdolescent cannabis use is associated with increased risk of psychosis even after adjustment for baseline prodromal symptoms, parental psychosis and other substance use.Declaration of interestNone.

Mental Disorders in Patients with Temporomandibular Pain-dysfunction Syndrome

2017 ◽  
Vol 41 (S1) ◽  
pp. S254-S254
Author(s):  
V. Medvedev ◽  
V. Frolova ◽  
Y. Fofanova
Keyword(s):  
Psychiatric Disorders ◽  
Affective Disorders ◽  
Inform Consent ◽  
Painful Condition ◽  
Schizotypal Personality ◽  
Icd 10 ◽  
Psychometric Method ◽  
Competing Interest ◽  
Depressive Episodes ◽  
Temporomandibular Pain

IntroductionMaxillofacial surgeons and dentists often deal with the phenomenon of temporomandibular pain-dysfunction syndrome–painful condition of maxillofacial area without clear organic pathology. Psychiatric studies of this disorder are almost lacking. The aim of this study was to determine the prevalence of psychiatric disorders in patients with temporomandibular pain-dysfunction syndrome and to define the psychiatric diagnosis (ICD-10).MethodsStudy sample consists of 57 patients (44 women and 13 men) with temporomandibular pain-dysfunction syndrome aged older than 18 years, who gave inform consent. The study used clinical psychopathological, psychometric (HADS, HDRS, State-Trait Anxiety Inventory, Hypochondria Whitley Index, Visual Analog Scale for Pain).ResultsPsychiatric disorders were revealed in 48 patients (84.2%) with temporomandibular pain-dysfunction syndrome–39 women and 9 men aged 18-65 years (mean age 39.6 ± 15.4 years). Affective disorders was diagnosed in 56.3%, personality disorders in 20.8%, schizotypal personality disorder in 12.5% and schizophrenia in 10.4%. Among affective pathology mild and moderate depressive episodes prevailed (59.3%). The severity of pain (VAS) in patients with affective disorders was higher than in patients with other psychiatric conditions.ConclusionThis study shows high prevalence of psychiatric disorders in patients with temporomandibular pain-dysfunction syndrome and proves the feasibility of a psychiatrist participate in the complex treatment of these patients. The use of psychometric method allows to improve the timeliness of the detection of patients who require further clinical psychopathological examination in order to determine the need of pharmacotherapy.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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