Bouffee delirante and ICD-10 acute and transient psychoses:: a comparative study

Objective: ICD-10 acute and transient psychotic disorder (ATPD; F23) has one of its historical roots in the French concept of bouffee delirante. This study explores the empirical relationship of the two concepts. Method: During a 5-year period, all inpatients with ATPD were identified; the diagnosis of bouffee delirante was 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, only 28.6% also fulfilled the criteria of bouffee delirante. Patients with bouffee delirante were significantly younger than the remaining ATPD patients. Outcome parameters were generally more favourable for patients diagnosed with bouffee delirante than for ATPD patients without a concurrent diagnosis of bouffee delirante, but the difference was statistically significant only for occupational status. Conclusions: There are indications that a diagnosis of bouffee delirante carries a somewhat better prognosis than ATPD in general. However, the low frequency of operationally diagnosed bouffee delirante suggests that the criteria might be too narrow.