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Duration of remitting psychoses with acute onset

Implications for ICD-10

Department of Psychiatry, Columbia University and New York State Psychiatric Institute

VIJOY VARMA, MD

Post-Graduate Institute of Medical Education and Research, Chandigarh, India

Correspondence: Ramin Mojtabai, MD, PhD, 200 Haven Avenue, Apt. 6P, New York, NY 10033, USA. Fax: (212) 781-6345; e-mail: rm322{at}columbia.edu

Declaration of interest Partial support detailed in Acknowledgements. No conflict of interest.

Background The acute and transient psychotic disorders (ATPD) in ICD-10 advanced the nosology of remitting psychoses with acute onset. But the proposed criteria for ATPD - especially in regard to duration - are tentative and need to be validated.

Aims To evaluate: (a) the duration of remitting psychoses with acute onset; (b) the applicability of the ATPD criteria for these cases; and (c) differences in duration and ATPD diagnoses across sociocultural settings.

Method Data from the World Health Organization Determinants of Outcome study were used.

Results The 98 cases of remitting psychoses with acute onset had a modal duration of 2-4 months, with 43% falling in this range. Mainly because of this, few met the ATPD criteria. Duration and diagnostic findings were similar across settings.

Conclusions ATPD criteria need refinement, especially in regard to duration. Further studies aimed at early detection and assessment of onset and duration of these disorders are needed.

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