The concordance of ICD-10 acute and transient psychosis and DSM-IV brief psychotic disorder.
BACKGROUND
ICD-10 acute and transient psychotic disorder (ATPD; F23) and DSM-IV brief psychotic disorder (BPD; 298.8) are related diagnostic concepts, but little is known regarding the concordance of the two definitions.


METHODS
During a 5-year period all in-patients with ATPD were identified; DSM-IV diagnoses were also determined. We systematically evaluated demographic and clinical features and carried out follow-up investigations at an average of 22 years after the index episode using standardized instruments.


RESULTS
Forty-two (4.1%) of 1036 patients treated for psychotic disorders or major affective episode fulfilled the ICD-10 criteria of ATPD. Of these, 61.9% also fulfilled the DSM-IV criteria of brief psychotic disorder; 31.0%, of schizophreniform disorder; 2.4%, of delusional disorder; and 4.8%. of psychotic disorder not otherwise specified. BPD showed significant concordance with the polymorphic subtype of ATPD, and DSM-IV schizophreniform disorder showed significant concordance with the schizophreniform subtype of ATPD. BPD patients had a significantly shorter duration of episode and more acute onset compared with those ATPD patients who did not meet the criteria of BPD (non-BPD). However, the BPD group and the non-BPD group of ATPD were remarkably similar in terms of sociodemography (especially female preponderance), course and outcome, which was rather favourable for both groups.


CONCLUSIONS
DSM-IV BPD is a psychotic disorder with broad concordance with ATPD as defined by ICD-10. However, the DSM-IV time criteria for BPD may be too narrow. The group of acute psychotic disorders with good prognosis extends beyond the borders of BPD and includes a subgroup of DSM-IV schizophreniform disorder.
Pillmann
F
F
Department of Psychiatry and Psychotherapy, Martin Luther University Halle-Wittenberg, Halle, Germany.
Haring
A
A
Balzuweit
S
S
Blöink
R
R
Marneros
A
A
D000208:Acute Disease; D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010343:Patient Admission; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data*; D011594:Psychometrics; D011618:Psychotic Disorders / Q000145:classification / Q000175:diagnosis* / Q000523:psychology / Q000628:therapy; D015203:Reproducibility of Results; D012559:Schizophrenia / Q000145:classification / Q000175:diagnosis; D012565:Schizophrenic Psychology