scholarly journals A three-month longitudinal study for diagnostic stability of acute and transient psychotic disorder

2017 ◽  
Vol 7 (3) ◽  
pp. 2-6
Author(s):  
Devavrat Joshi ◽  
Ananta Prasad Adhikari ◽  
Praveen Bhattarai ◽  
Pawan Sharma
Keyword(s):  
Mental Hospital ◽  
Psychotic Disorders ◽  
Acute Stress ◽  
Diagnostic Category ◽  
Severe Depression ◽  
Complete Recovery ◽  
Initial Diagnosis ◽  
First Episode ◽  
Diagnostic Stability ◽  
Number Of Patients

Background: The diagnostic category of “acute and transient psychotic disorders” (ATPD) comprises of psychotic disorders with features of acute onset (within 2 weeks), presence of typical syndromes that are either polymorphic or schizophrenic or persistently delusional, evidence for associated acute stress and complete recovery in most cases within 2–3 months. Studies of diagnostic stability among patients with the initial diagnosis of ATPD at their first admission have reported modest stabilities spanning over different periods of time, with higher levels of stability reported in samples from the developing countries. This study aimed at investigating the diagnostic stability of cases of ATPD at the Mental Hospital, Lagankhel over a period of 3 months from the first diagnosis. Methods: ASeventy-five drug naïve patients with the initial diagnosis of first episode ATPD admitted at the in-patient unit of Mental Hospital, Lagankhel were followed up longitudinally and their diagnosis was assessed independently by two consultant psychiatrists over a period of 3 months. Results: Average age of the sample was 30.71 years. 66.7% of the cases retained their index diagnosis of ATPD at 3 months, while the remaining required diagnostic revision. A higher number of patients had their diagnosis revised to Affective Disorders including Mania and Severe depression with psychotic features (13.88%) when compared to Schizophrenia (6.94%). Conclusion: ATPD is a relatively stable diagnostic category in the Nepalese Scenario as well with more than two third of the patients retaining the initial diagnosis at 3 months.

Incidence of schizophrenia in Nottingham

1997 ◽  
Vol 171 (2) ◽  
pp. 140-144 ◽  
Author(s):  
J. Brewin ◽  
R. Cantwell ◽  
T. Dalkin ◽  
R. Fox ◽  
I. Medley ◽  
...  
Keyword(s):  
Psychotic Disorders ◽  
Diagnostic Category ◽  
Incidence Rates ◽  
World Health ◽  
First Episode ◽  
Episode Psychosis ◽  
Real Change ◽  
Icd 10 ◽  
Health Organization ◽  
Methodological Considerations

BackgroundSeveral studies have reported a decline of up to 50% in the incidence of schizophrenia over recent decades. We aimed to measure changes in the incidence and diagnostic patterns of first-episode psychosis by comparing two Nottingham cohorts, identified in two equal periods separated by 14 years.MethodTwo prospectively ascertained cohorts of first-episode psychotic disorder were identified over the time periods 1978–80 and 1992–94. The earlier cohort was of the World Health Organization Determinants of Outcome of Severe Mental Disorder (DOSMD) ten-country study. The later cohort was obtained using similar methodology. Both groups were diagnosed using ICD-10 diagnostic criteria and age-standardised incidence rates were compared.ResultsThe standardised incidence rate for all psychotic disorders rose slightly from 2.49 to 2.87 per 10 000 population per year, but the F20 classification fell significantly by over a third (1.41 to 0.87 per 10 000 per year). The second study group (1992–1994) included a greater diversity of psychotic diagnoses compared with the first, in particular an increased proportion of acute and drug-related psychoses.ConclusionsMethodological considerations call for caution in interpreting such data, but we conclude that the significant fall in the narrowly defined diagnostic category of schizophrenia reflects a real change in the syndromal presentation of psychotic disorders.

Diagnostic Stability 2 Years After Treatment Initiation in the Early Psychosis Intervention Programme in Singapore

2007 ◽  
Vol 41 (6) ◽  
pp. 495-500 ◽  
Author(s):  
Mythily Subramaniam ◽  
Elaine Pek ◽  
Swapna Verma ◽  
Yiong Huak Chan ◽  
Siow Ann Chong
Keyword(s):  
Psychotic Disorders ◽  
Early Psychosis ◽  
Psychotic Symptoms ◽  
First Episode ◽  
Intervention Programme ◽  
Affective Psychosis ◽  
Diagnostic Stability ◽  
Schizophrenia Spectrum ◽  
Axis I ◽  
First Contact

Objective: To evaluate the diagnostic stability of psychotic disorders over a 2 year period in patients presenting with first-episode psychosis. Methods: One hundred and fifty-four patients were recruited from an early psychosis intervention programme (EPIP). They were diagnosed by the attending psychiatrist using the Structured Clinical Interview for DSM-IV Axis I at first contact (baseline) and after 24 months. The diagnoses were classified into the following categories: schizophrenia spectrum disorders (schizophrenia, schizophreniform disorder and schizoaffective disorder), affective psychosis (bipolar and major depressive disorders with psychotic symptoms), and other non-affective psychosis (delusional disorder, psychosis not otherwise specified and brief psychotic disorder). Two measueres of stability, the prospective and the retrospective consistency were determined for each diagnosis. Results: The diagnoses with the best prospective consistency were schizophrenia (87.0%) and affective psychosis (54.5%). The shift into schizophrenia spectrum disorder was the most frequent diagnostic change. Duration of untreated psychosis was found to be the only significant predictor of shift. Conclusion: It is difficult to make a definitive diagnosis at first contact. The clinical need to review the diagnosis throughout the period of follow up is emphasized.

scholarly journals Return to College After a First Episode of Psychosis

2020 ◽  
Vol 1 (1) ◽  
Author(s):  
Ann K Shinn ◽  
Philip B Cawkwell ◽  
Kirsten Bolton ◽  
Brian C Healy ◽  
Rakesh Karmacharya ◽  
...  
Keyword(s):  
Psychotic Disorders ◽  
Psychiatric Hospitalization ◽  
Diagnostic Category ◽  
College Education ◽  
First Episode ◽  
Educational Goals ◽  
Educational Success ◽  
Return To College ◽  
Record Review

Abstract A first episode of psychosis (FEP) can derail a patient’s educational goals, including attainment of a college education, and this can have lasting ramifications for socioeconomic and health outcomes. Despite this, few studies have examined return to college, which is an important index of real-world educational success after a FEP. In this study, we conducted a longitudinal medical record review of patients in a transdiagnostic outpatient FEP program and performed survival analysis, setting return to college as the endpoint, among the subset of patients whose college education was interrupted. We found that 82% (93/114) of college-enrolled FEP individuals experienced disruptions to their education after FEP, but that return to college also occurred in a substantial proportion (49/88, 56%) among those on leave who had follow-up data. In this sample, the median time to college return was 18 months. When separated by baseline diagnostic category, FEP patients with affective psychotic disorders (FEAP, n = 45) showed faster time to college return than those with primary psychotic disorders (FEPP, n = 43) (median 12 vs 24 mo; P = .024, unadjusted). When adjusted for having no more than 1 psychiatric hospitalization at intake and absence of cannabis use in the 6 months prior to intake (which were also significant predictors), differences by diagnostic category were more significant (hazard ratio 2.66, 95% CI 1.43–4.94, P = .002). Participation in education is an important outcome for stakeholders, and students with FEP can be successful in accomplishing this goal.

scholarly journals Attitudes to referral to community mental health teams: a questionnaire study

2005 ◽  
Vol 29 (6) ◽  
pp. 213-214 ◽  
Author(s):  
P. Walker ◽  
O.G. Haeney ◽  
P.C. Naik
Keyword(s):  
Mental Health ◽  
Community Mental Health ◽  
General Practitioners ◽  
Psychotic Disorders ◽  
Acute Stress ◽  
Severe Depression ◽  
Mild Depression ◽  
Referral Patterns ◽  
Panic Disorders ◽  
Acute Stress Reaction

Aims and MethodThere are no data or guidelines on who should be referred to community mental health teams (CMHTs), resulting in enormous variability in referral patterns. General practitioners (GPs) and psychiatrists were surveyed using a purpose-designed questionnaire to assess their attitudes regarding referral of individuals with different psychiatric disorders.ResultsThere was consensus among GPs and psychiatrists that individuals with psychotic disorders, mania, severe depression and phobias should be referred to CMHTs. GPs were more likely to refer personality disorder, whereas the reverse was true for moderate depression and anxiety/ panic disorders. There was disagreement within groups about referral for acute stress reaction, mild depression and adjustment disorders.Clinical ImplicationsUncertainty about appropriate referral causes variability in referral patterns and service provisions. This needs resolution through the Royal Colleges of Psychiatrists and General Practitioners, to provide guidance leading to equality of care for all.

Gender differences in acute and transient psychotic disorder

2016 ◽  
Vol 33 (S1) ◽  
pp. S364-S364
Author(s):  
Á. López Díaz ◽  
S. Galiano Rus ◽  
A. Soler Iborte ◽  
J.L. Fernández González ◽  
J.I. Aznarte López
Keyword(s):  
Gender Differences ◽  
Psychotic Disorders ◽  
Acute Stress ◽  
Clinical Symptoms ◽  
Statistical Significance ◽  
Stressful Events ◽  
Psychotic Symptoms ◽  
Psychiatric Ward ◽  
Cross Sectional ◽  
Diagnostic Stability

IntroductionIn the recent decades, there is a growing interest in gender differences in psychotic disorders. Also, in the field of acute and transient psychosis, according to various studies, women seem to have higher prevalence and long-term diagnostic stability.ObjectivesTo determine whether there are gender differences in clinical features of acute and transient psychotic disorders (ATPD).MethodsDescriptive cross-sectional study in the adult patients with ATPD were admitted between 2011 and 2015 in our acute psychiatric ward. Diagnostic criteria was according to the International Classification of Diseases (ICD-10). Descriptive and inferential statistic procedures for clinical symptoms and diagnostic subcategories were performed, using the MedCalc software, version 15.8.ResultsThirty-nine patients met the inclusion criteria. Males were (MG) 41%, females (FG) 59%. There were some statistically significant differences between gender in the polymorphic features group (>FG, P = 0.048), and in the presence of acute stress (>FG, P = 0.0277). Length of stay was also different, but without statistical significance (>MG, P = 0.0607). In contrast, symptomatic sets, family history of psychosis, and type of onset (sudden or acute) were similar for both groups.ConclusionsThe gender differences seem to be in favour of a higher prevalence of polymorphic psychotic symptoms, in relation to stressful events in women. Somehow, these factors could be a condition, which would determine a greater diagnostic stability in female patients, even in cases of recurrences.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Diagnostic Stability of Primary Psychotic Disorders in a Research Sample

2021 ◽  
Vol 12 ◽  
Author(s):  
Andrea J. Wood ◽  
Amber R. Carroll ◽  
Ann K. Shinn ◽  
Dost Ongur ◽  
Kathryn E. Lewandowski
Keyword(s):  
Bipolar Disorder ◽  
Schizoaffective Disorder ◽  
Psychotic Disorders ◽  
Clinical Care ◽  
Total Sample ◽  
Initial Diagnosis ◽  
Schizophreniform Disorder ◽  
Change Rate ◽  
Diagnostic Stability ◽  
Not Otherwise Specified

Psychiatric diagnosis is often treated as a stable construct both clinically and in research; however, some evidence suggests that diagnostic change may be common, which may impact research validity and clinical care. In the present study we examined diagnostic stability in individuals with psychosis over time. Participants with a diagnosis of any psychotic disorder (n = 142) were assessed at two timepoints using the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders. We found a 25.4% diagnostic change rate across the total sample. People with an initial diagnosis of psychosis not otherwise specified and schizophreniform disorder had the highest rates of change, followed by those with schizophrenia and schizoaffective disorder; people with bipolar disorder had the lowest change rate. Most participants with an unstable initial diagnosis of schizophrenia, schizophreniform disorder, bipolar disorder, or psychosis not otherwise specified converted to a final diagnosis of schizoaffective disorder. Participants with an unstable initial diagnosis of schizoaffective disorder most frequently converted to a diagnosis of schizophrenia. Our findings suggest that diagnostic change is relatively common, occurring in approximately a quarter of patients. People with an initial diagnosis of schizophrenia-spectrum disorder were more likely to have a diagnostic change, suggesting a natural stability of some diagnoses more so than others.

QUALITY OF INDIVIDUAL AND GROUP LEVEL INTERVENTIONS FOR FIRST EPISODE PSYCHOSIS AT THE TERTIARY PSYCHIATRIC HOSPITAL IN UGANDA.

2020 ◽  
Author(s):  
Emmanuel Kiiza Mwesiga ◽  
Noeline Nakasujja ◽  
Lawrence Nankaba ◽  
Juliet Nakku ◽  
Seggane Musisi
Keyword(s):  
Psychiatric Hospital ◽  
Psychotic Disorders ◽  
First Episode Psychosis ◽  
First Episode ◽  
Group Level ◽  
Group Interventions ◽  
Episode Psychosis ◽  
Essential Components ◽  
The Individual

Introduction: Individual and group level interventions have the largest effect on outcomes in patients with the first episode of psychosis. The quality of these individual and group level interventions provided to first-episode psychosis patients in Uganda is unclear.Methods: The study was performed at Butabika National Psychiatric Teaching and referral hospital in Uganda. A retrospective chart review of recently discharged adult in-patients with the first episode of psychosis was first performed to determine the proportion of participants who received the different essential components for individual and group level interventions. From the different proportions, the quality of the services across the individual and group interventions was determined using the first-Episode Psychosis Services Fidelity Scale (FEPS-FS). The FEPS-FS assigns a grade of 1-5 on a Likert scale depending on the proportion of patients received the different components of the intervention. Results: The final sample included 156 first-episode psychosis patients. The median age was 27 years [IOR (24-36)] with 55% of participants of the female gender. 13 essential components across the individual and group interventions were assessed and their quality quantified. All 13 essential components had poor quality with the range of scores on the FEPS-FS of 1-3. Only one essential component assessed (use of single antipsychotics) had moderate quality.Discussion: Among current services at the National psychiatric hospital of Uganda, the essential for individual and group level interventions for psychotic disorders are of low quality. Further studies are required on how the quality of these interventions can be improved.

Sign in / Sign up

Export Citation Format

Share Document