Prognostic significance of psychotic relapse in patients with first-episode acute and transient psychosis: New empirical support for ICD-11.

Autor: López-Díaz Á; UGC Salud Mental, Hospital Universitario Virgen Macarena, Seville, Spain; Centro de Investigación Biomédica en Red Salud Mental (CIBERSAM), Seville, Spain; Instituto de Biomedicina de Sevilla (IBIS), Seville, Spain. Electronic address: alvaro.lopez.diaz.sspa@juntadeandalucia.es., Fernández-González JL; UGC Salud Mental, Hospital San Juan de la Cruz, Úbeda, Spain., Lara I; UGC Salud Mental, Hospital Universitario Virgen Macarena, Seville, Spain., Crespo-Facorro B; Centro de Investigación Biomédica en Red Salud Mental (CIBERSAM), Seville, Spain; Instituto de Biomedicina de Sevilla (IBIS), Seville, Spain; UGC Salud Mental, Hospital Universitario Virgen del Rocío, Seville, Spain; Departamento de Psiquiatría, Universidad de Sevilla, Spain., Ruiz-Veguilla M; Centro de Investigación Biomédica en Red Salud Mental (CIBERSAM), Seville, Spain; Instituto de Biomedicina de Sevilla (IBIS), Seville, Spain; UGC Salud Mental, Hospital Universitario Virgen del Rocío, Seville, Spain; Departamento de Psiquiatría, Universidad de Sevilla, Spain.
Jazyk: angličtina
Zdroj: Journal of psychiatric research [J Psychiatr Res] 2021 May; Vol. 137, pp. 486-490. Date of Electronic Publication: 2021 Mar 18.
DOI: 10.1016/j.jpsychires.2021.03.023
Abstrakt: This study examined the impact of psychotic relapse on the diagnostic stability of acute and transient psychotic disorders (ATPD), and how this potential risk factor could differentiate 'acute polymorphic psychotic disorder without symptoms of schizophrenia' (APPD; ICD-10 code F23.0) from the remaining non-APPD subtypes (F23.1-9). A two-year cohort study was performed on 68 patients with first-episode ATPD. At the end of follow-up, the diagnostic stability of ATPD was 55.9% and the overall rate of psychotic relapse was 61.8%. Statistical analysis showed that recurrence was an independent risk factor for diagnostic shift in ATPDs (relative risk [RR] = 1.67, 95% confidence interval [CI] = 1.17-2.39; p = 0.005) and that this risk differed among their subtypes insofar as its appearance significantly increased the likelihood of diagnostic change in patients with non-APPD subtypes (RR = 2.52, 95% CI = 1.56-4.07; p < 0.001), but not in those with APPD (RR = 0.95, 95% CI = 0.57-1.57; p = 0.844). Our findings confirm the negative implications of recurrence in patients with ATPD, encourage long-term intervention targeting relapse prevention in this population, and provide new empirical evidence in support of narrowing the ATPD category to APPD in the upcoming ICD-11.
(Copyright © 2021 Elsevier Ltd. All rights reserved.)
Databáze: MEDLINE
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