title: Brief reactive psychosis and the major functional psychoses: descriptive case studies in Africa.
abstract: In a three-year prospective study of service-based incidence of functional psychoses in Africa, 94 cases of brief reactive psychosis were compared with 56 cases of schizophreniform syndromes, 29 cases of DSM-III schizophrenia and 14 of manic-depressive psychosis. This was supplemented by retrospective study of the same syndromes not in their first episode. Brief reactive psychosis was found to be a composite syndrome. The 50% with preceding depression were a distinct group, in terms of course and demographic features. Of those with intense prodromal anxiety, most were a single episode precipitated by a major life event, a few showed a recurrent long-term pattern. Schizophrenia was heralded, or presented unequivocally months or years later, in 10-20%. The schizophreniform group comprised a range of atypical psychoses intermediate between the transient and major psychoses. The pattern of precipitants and the over-representation of education and paid employment in the acute syndromes, compared with the major psychoses, in a society which was largely first-generation educated, suggested a link with rapid social change.
authors.forename: E A
authors.initials: EA
authors.lastname: Guinness
mesh_terms: D000293:Adolescent; D000328:Adult; D001714:Bipolar Disorder / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D003430:Cross-Sectional Studies; D003702:Delusions / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D003906:Developing Countries; D013541:Eswatini / Q000453:epidemiology; D005260:Female; D006801:Humans; D015994:Incidence; D008016:Life Change Events; D008297:Male; D011247:Pregnancy; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D011605:Psychoses, Substance-Induced / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D011618:Psychotic Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D012008:Recurrence; D012307:Risk Factors; D012559:Schizophrenia / Q000175:diagnosis / Q000453:epidemiology*; D012565:Schizophrenic Psychology; D012922:Social Change; D012931:Social Environment; D014507:Urbanization