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. Method. 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 2.2 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.