Diagnostic stability of acute and transient psychotic disorder: A systematic review and meta-analysis

Abstract

IntroductionThe validity and diagnostic stability of acute and transient psychotic disorder (ATPD) has been questioned by several authors, since its introduction in the International Statistical Classification of Diseases (ICD-10).ObjectiveTo determine the overall diagnostic stability of ATPD in scientific literature.MethodA systematic review and meta-analysis of prospective studies and retrospective chart reviews. Computerized search was performed in MEDLINE/PubMed, EMBASE, and Google Scholar, using the terms: “acute and transient psychotic disorder”, or “acute psychosis”, and “stability”, or “outcome”, or “long-term”, or “follow-up”, or “course”. Search was restricted to works in English published between 1993 and 2015, according to ICD-10 criteria. Opinion articles, individual case reports, researches with less than ten subjects, and overlapping studies were excluded. Data analysis was conducted using MedCalc software, version 15.8. Statistical procedure was calculated for meta-analysis of proportions.ResultsTwenty-six studies met the inclusion criteria (n = 10852). For methodological purposes, a distinction was made between short-term (less than 2 years), medium-term (between 2–7 years), and long-term stability (more than 7 years). For short-term group (k = 5), the overall stability was 60.69% (fixed effects model); Cochran's heterogeneity statistic Q = 14.9, I2 = 73.15%, P = 0.0049. For medium-term group (k = 15), it was 49.99%; Q = 181.6, I2 = 92.29%, P < 0.0001. For long-term group (k = 6), it was 61.86%; Q = 35.12, I2 = 92.29%, P < 0.0001.ConclusionThe global stability of ATPD indicates at the validity of the construct, but should be redefined in future revisions of ICD, to clarify better diagnostic criteria, and more predictive power.Disclosure of interestThe authors have not supplied their declaration of competing interest.