Acute and transient psychosis: An overview

Abstract

The tenth revision of the International Classification of Mental and Behavioural Disorders (ICD-10) introduced the category F23 ‘acute and transient psychotic disorders’ (ATPDs) and the diagnostic and statistical manual of mental disorders, and fourth edition (DSM-IV) introduced the concept of brief and acute psychosis to incorporate different concepts of brief and acute psychoses, which were reported from different parts of world as early as middle of the nineteenth century. Over the past 150 years, a lot of work has been done to recognise this concept as a distinct entity. ATPD is reported as, being prevalent in females, in early to middle adulthood, being more common in low socio-economic status, and in those from a rural background. Acute stress has been recognised as a precipitating factor with family history of psychiatric illness, increasing the risk of ATPD. Although follow-up studies suggest that its outcome is more favourable than other disorders in the F20 group, ATPD tends to recur and variable numbers of patients convert mainly into either schizophrenia or affective disorders. There has been considerable interest in this entity, especially for its relatedness or its distinctiveness from the other two well-known psychotic conditions namely schizophrenia and mood disorders with psychotic symptoms. There are family genetic studies as well as some neurobiological studies on ATPD. Nevertheless, the nature of this group of psychotic conditions is still unclear and controversial and remains a fertile ground for continued research in this area. In this chapter, research and developments on the subject of ATPDs are reviewed and critically examined from the clinical perspective and traced on to the most recent viewpoints.