Diagnostic stability over 3 years in a total group of first-episode psychosis patients.
First-episode psychosis (FEP) patients are often given diagnoses that later have to be changed. The aim of this study was to measure the diagnostic stability in a total group of FEP patients; 146 FEP patients were followed longitudinally and prospectively. Their revised baseline diagnoses were compared with their 3-year follow-up diagnoses. The schizophrenic spectrum disorders showed a high diagnostic stability as a group, but there was a great flow of patients between the different schizophrenic spectrum diagnoses. Also schizophrenia was a stable diagnosis. The affective psychosis group was homogenous without interaction of other psychosis groups. The other psychosis diagnoses, both regarded as a group and individually, turned out to be quite heterogeneous, with low stability values and a split course, often ending up in the schizophrenic spectrum. Fifty one per cent did not fulfil the criteria for DSM-IV axis 1 psychosis diagnosis at follow-up. In conclusion, our findings suggest that in the early phase of psychosis. Only three different diagnostic categories would be sufficient; "schizophrenic spectrum type", "affective psychosis," and for the rest "psychotic disorder NOS."
Rahm
Christoffer
C
Psychiatric Clinic, M56, Karolinska University Hospital, Huddinge, Sweden. Christoffer.Rahm@sll.se
Cullberg
Johan
J
D000293:Adolescent; D000328:Adult; D015331:Cohort Studies; D039721:Diagnostic and Statistical Manual of Mental Disorders; D018450:Disease Progression; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008875:Middle Aged; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D011618:Psychotic Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D015203:Reproducibility of Results; D012559:Schizophrenia / Q000175:diagnosis; D012565:Schizophrenic Psychology; D013548:Sweden; D009626:Terminology as Topic