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

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

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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.

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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

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Clinical manifestations in patients with acute and transient psychosis

European Psychiatry ◽

10.1016/j.eurpsy.2016.01.1303 ◽

2016 ◽

Vol 33 (S1) ◽

pp. S363-S364

Author(s):

Á. López Díaz ◽

A. Soler Iborte ◽

S. Galiano Rus ◽

J.L. Fernández González ◽

J.I. Aznarte López

Keyword(s):

Psychotic Disorder ◽

Psychotic Disorders ◽

Clinical Manifestations ◽

Retrospective Chart Review ◽

International Classification Of Diseases ◽

Exact Test ◽

Chi Squared ◽

Classification Of Diseases ◽

Icd 10 ◽

Competing Interest

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.

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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.

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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

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Does Gender Influence Electroconvulsive Therapy Sessions Required across Psychiatric Diagnoses? A 5-Year Experience from a Single Center

Journal of Neurosciences in Rural Practice ◽

10.4103/jnrp.jnrp_482_16 ◽

2017 ◽

Vol 08 (03) ◽

pp. 427-430 ◽

Cited By ~ 4

Author(s):

Harshini Manohar ◽

Karthick Subramanian ◽

Vikas Menon ◽

Shivanand Kattimani

Keyword(s):

Electroconvulsive Therapy ◽

Psychotic Disorders ◽

Tertiary Care ◽

International Classification Of Diseases ◽

Yield Response ◽

Psychiatric Diagnoses ◽

Care Hospital ◽

Dose Requirement ◽

Related Data ◽

And Gender

ABSTRACTContext: There is a paucity of systematic data reflecting the practice of electroconvulsive therapy (ECT) from developing countries. Aim: We aimed to identify the number of ECT sessions required to yield response and gender differences in the number of sessions across various diagnostic categories. Setting and Design: A record-based study from a teaching cum tertiary care hospital in South India. Subjects and Methods: Case records of patients who received modified ECT from January 2011 to January 2016 were reviewed. The sociodemographic details and ECT-related data were collected. Psychiatric diagnoses were ascertained as per the International Classification of Diseases, 10th Revision criteria. Statistical Analysis Used: Kruskal–Wallis test and Mann–Whitney U-test. Results: Among 148 patients, 82 (55.4%) had mood disorder (bipolar disorder and recurrent depressive disorder), 43 (29.1%) had schizophrenia, and 22 (14.9%) had other acute and transient psychotic disorders (ATPDs). Patients with mood disorders, schizophrenia, and other ATPD received 7.3 (± 3.8), 9.7 (± 6.1), and 5.4 (± 2.0) ECT sessions, respectively, to achieve response. There was no gender difference in the number of sessions received. Conclusion: Our findings show that number of ECT sessions required to yield response may be disorder-specific. Gender does not influence the ECT dose requirement. Variations in ECT parameters across settings may limit the generalizability of results.

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The impact of the Tsunami on hospitalzations at the tertiary care hospital in the Southern Province of Sri Lanka

American Journal of Disaster Medicine ◽

10.5055/ajdm.2008.0020 ◽

2008 ◽

Vol 3 (3) ◽

pp. 147-155 ◽

Cited By ~ 5

Author(s):

Truls Østbye, MD, PhD ◽

Thyagi Ponnamperuma, MBBS ◽

Nayana Fernando, MBBS, MSc ◽

Vathsala Abeygunawardena, MSc ◽

W.A.A. Wijayasiri, MBBS, MSc ◽

...

Keyword(s):

Hospital Admissions ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

International Classification Of Diseases ◽

Care Hospital ◽

Disease Patterns ◽

Disaster Relief Operations ◽

Classification Of Diseases ◽

Relief Operations ◽

The Impact

Objective: Sri Lanka’s human, physical, social, and economic resources suffered a massive impact after the tsunami of December 26, 2004. To assist in preparing for future disasters, the authors sought to characterize the pattern of hospitalizations from the main impact zone in the Southern Province.Design: Retrospective chart review.Setting: Patients admitted to Teaching Hospital, Karapitiya, the only tertiary care hospital in the Southern Province.Patients, Participants: All hospital admissions on the day of and week following the tsunami, and a random sample (5 percent) of admissions from the month preceding, and the 3 months following the tsunami were coded according to the International Classification of Diseases, 10th Edition, analyzed, and geomapped.Intervention: N/A.Main Outcome Measure(s): The overall daily number of hospitalizations increased by 50 percent on the day of the tsunami and decreased in the following week.Results: Before the tsunami, injuries typically accounted for 20 percent of hospital admissions. However, injuries were markedly higher (89 percent of the total) on the day of the tsunami and remained elevated (35 percent) during the following week. After the initial peak in injuries (including near drownings), there was no increase in the frequency of infectious, cardiac, or psychiatric admissions.Conclusions: Injuries (including near drownings) were the most common cause of admissions immediately after the tsunami.The distribution of specific diagnoses differed from that seen after other natural disasters such as earthquakes and hurricanes. A central aspect of disaster relief operations and planning includes a thorough understanding of the postdisaster health effects and changes in disease patterns.

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A clinical study of neurological soft signs in patients with schizophrenia

Journal of Neurosciences in Rural Practice ◽

10.4103/0976-3147.181481 ◽

2016 ◽

Vol 07 (03) ◽

pp. 393-399

Author(s):

Mithun Dutta ◽

Kamal Nath ◽

Aparajeeta Baruah ◽

Subrata Naskar

Keyword(s):

Tertiary Care ◽

International Classification Of Diseases ◽

Care Hospital ◽

Neurological Soft Signs ◽

Duration Of Illness ◽

Classification Of Diseases ◽

Objectively Measured ◽

Pro Forma ◽

Illness Variables

ABSTRACT Background and Aim: Neurological soft signs (NSSs) are “objectively measured, nonlocalizing abnormalities, not related to impairment of a specific brain region, reflecting improper cortical-subcortical and intercortical connections.” The possibility of NSS as an endophenotype in schizophrenia has been studied across the globe. We aimed at finding the prevalence of NSS among patients with schizophrenia as well as the associations of NSS between various sociodemographic and illness variables. Subjects and Methods: One hundred patients between the age group of 16 and 60 years were serially selected from the inpatient department of a tertiary care hospital who have been diagnosed as a case of schizophrenia according to the International Classification of Diseases version 10 during 1 year period. A semi-structured pro forma was used to collect various demographic as well as illness data, and subjects were clinically evaluated for NSS using neurological evaluation scale. Results: The prevalence of NSSs was found to be 67%, significant association was found between NSS and age, occupation, and duration of illness. A statistically significant correlation was found between NSS and age, NSS and duration of illness. Conclusion: The validity of NSS as an endophenotype lies in the fact that it should be independent of all sociodemographic and illness variables. However, our study evaluated some statistically significant findings between them. Hence, further researches are required with properly adjusted controls to find if the associations obtained between NSS and different variables here are true or whether there are some confounding factors included.

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Rehabilitation of the patients with myasthenia gravis as an Integral part of the patient’s Treatment Algorithm in the postoperative period

Acta Balneologica ◽

10.36740/abal202103104 ◽

2021 ◽

Vol 64 (3) ◽

pp. 155-159

Author(s):

Olena L. Tovazhnyanska ◽

Olena M. Klimova ◽

Hanna P. Samoilova ◽

Dmytro V. Minukhin ◽

Kateryna V. Ponomarova ◽

...

Keyword(s):

Myasthenia Gravis ◽

Treatment Algorithm ◽

International Classification Of Diseases ◽

Medical Sciences ◽

Urgent Surgery ◽

Classification Of Diseases ◽

Icd 10 ◽

Class Iib ◽

Severity Of The Disease

Aim: The purpose of this article is to determine the role of rehabilitation in the structure of the treatment algorithm for patients with myasthenia gravis. materials and methods: All patients admitted to the SI «Zaycev V.T. Institute of General and Urgent surgery of National Academy of Medical Sciences of Ukraine», Kharkiv, Ukraine for surgical treatment for thymoma or carcinoma of the thymus gland. 102 people aged 18 to 69 with myasthenia have been comprehensively surveyed and their data have been analyzed and studied. Diagnosis of myasthenia was established according to the tenth edition of the International Classification of Diseases ICD-10 (WHO, 1992). Results: The severity of the patients’ condition corresponded to grade IIIA in 5 patients (16.7%), IIIB grade – 14 patients (46.7%), IVA grade – 7 patients (23.3%), IVB grade – in 4 patients (13.3%). According to the clinical classification of MGFA, the severity of the condition in most patients in this group corresponded to Class IIB (32.4%) and IIIA class (35.2%). Conclusions: The results of our study suggest that clinical and anamnestic features of myasthenia in absence of structural thymus disorders are debut before the age of 40 years, predominant affection of skeletal muscles, mild course (severity of the disease corresponds to 12.7 ± 1.76 points on the QMGS scale) and characterized by a debut after 40 years regardless of sex, manifestation of generalized muscle weakness and severe course (in 68.4% of cases severity of the disease was 31.68 ± 3.76 points on the QMGS scale).

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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.

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