Transition to schizophrenia in acute and transient psychoticdisorders

Transition to schizophrenia in acute and transient psychoticdisorders

BackgroundThe diagnostic category of acute and transient psychotic disorders (ATPD)was introduced in ICD-10. Subsequent studies have called into questionits validity and reliability.AimsTo determine the pattern of diagnostic revision to schizophrenia infirst-ever diagnosed ATPD.MethodUsing data draw...

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Bibliographic Details
Published in:British journal of psychiatry 2014-04, Vol.204 (4), p.299-305
Main Authors: Queirazza Filippo, Semple, David M, Lawrie, Stephen M
Format: Article
Language:eng
Subjects:
Age
Age of onset
Averages
Gender
High risk
Hospitalization
Mental disorders
Mental health
Morbidity
Patients
Psychiatry
Psychosis
Reliability
Schizophrenia
Survival analysis
Validity
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Summary:BackgroundThe diagnostic category of acute and transient psychotic disorders (ATPD)was introduced in ICD-10. Subsequent studies have called into questionits validity and reliability.AimsTo determine the pattern of diagnostic revision to schizophrenia infirst-ever diagnosed ATPD.MethodUsing data drawn from the Scottish Morbidity Record, we estimatedincidence and diagnostic change in first-ever diagnosed ATPD in Scottishhospitals between January 1997 and December 2010 (n =2923).ResultsThe average incidence of ATPD was 4.1 per 100 000 population per year.Diagnostic stability was estimated at 53.9% over an average ofapproximately 4 years of observation. The most common diagnostic shiftwas to schizophrenia (12.6%), over an average of 1.7 years. Estimates ofthe transition risks for schizophrenia were 80% at 2.8 years and 90% at4.6 years. Longer first admission to hospital, younger age at onset andmale gender were associated with increased risk and earlier developmentof schizophrenia.ConclusionsRoutinely collected data suggest that approximately one in eightindividuals with first-ever diagnosed ATPD will develop schizophreniawithin 3–5 years. Those at high risk of transition may benefit frommonitoring for possible diagnostic change.
ISSN:0007-1250
1472-1465