Transient Psychotic Disorders Research Articles

Historical and conceptual features of acute polymorphic psychosis: a myth of European psychiatry from bouffée délirante to ICD-11 acute and transient psychotic disorder.

This paper deals with the history and epistemology of acute polymorphic psychosis. We undertook a comparative study of short-lived psychotic disorders used in different European countries since the late nineteenth century. The theory of degeneration offered a speculative basis to conceptualization of conditions such as bouffée délirante, cycloid psychosis and reactive psychosis, but it seems likely that different factors contributed to the profusion of clinical concepts with adverse effects on both nomenclature and classification. The resulting picture suggests that earlier nosological concepts tend to converge on common descriptive features and challenge the diagnostic categories for short-lived psychotic disorders listed in modern symptom-based psychiatric classifications.

Longitudinal course of core cognitive domains in first-episode acute and transient psychotic disorders compared with schizophrenia

Acute and transient psychotic disorder (ATPD) is characterized by acute onset of psychotic symptoms and early recovery. Contrastingly, schizophrenia (SZ) is a chronic mental disorder characterized by impaired functioning including a deficit in cognition. In SZ, the cognitive deficit is among the core symptoms, but in ATPDs, the existing evidence brings mixed results. Our primary aim was to compare three core cognitive domains (executive functioning/abstraction, speed of processing and working memory) of patients diagnosed with ATPD and SZ over a 12-month period. Moreover, we explored how these diagnostic subgroups differed in their clinical characteristics. We recruited 39 patients with a diagnosis of SZ and 31 with ATPD with schizophrenic symptoms. All patients completed clinical and neuropsychological assessments. At baseline, we used a one-way ANCOVA model with a group as the between-subjects factor. Mixed-model repeated-measures ANOVAs with time as the within-subjects factor and group as the between-subjects factor were run to test the overtime differences. At baseline, we did not find any differences in cognition - with sex, education and age as covariates - between ATPDs and SZ. After one year, all patients showed an improvement in all three domains, however, there were no significant overtime changes between ATPDs and SZ. Regarding clinical profiles, ATPDs demonstrated less severe psychopathology and better functioning compared to SZ both at baseline and after 12 months. The medication dosage differed at retest, but not at baseline between the groups. Our findings suggest clinical differences and a similar trajectory of cognitive performance between these diagnostic subgroups.

The Prevalence of Hyperuricemia and the Association Between Hyperuricemia and Age in Patients with Psychiatric Disorders to a General Hospital: A Cross-Section Study.

In clinical work, it has been found that the prevalence of hyperuricemia (HUA) is significantly higher in younger patients with psychiatric disorders, but there are few studies in this area. The present study aims to evaluate the prevalence of HUA and the relationship between the HUA and age in hospitalized patients with psychiatric disorders in the real world, and to provide a theoretical basis for clinical staff to pay attention to the metabolic indicators of younger patients and for future related studies. This is a cross-sectional evaluation of a cohort of 1761 patients with psychiatric disorders of hospitalized. The categories of disorders designed for study included: Depression, Bipolar disorder, Schizophrenia, Anxiety, Obsessive-Compulsive disorder, Acute and transient psychotic disorder, Dissociative(conversion) disorders, Conduct disorders and Tic disorders. In addition, based on age, the participants are stratified into three groups. The authors used Kruskal-Wallis tests, chi-square tests, and multiple linear logistic regression to verify the relationship between HUA and age among hospitalized patients with psychiatric disorders. Overall, the estimated prevalence of HUA was 35.4%. The prevalence of HUA was significantly higher in individuals with 17 years and under compared to those with 45 years and above (P < 0.001). After adjusting for confounders, the prevalence of HUA remained higher at 17 years and under than at 45 years and above. Bipolar disorder can lead to an increased prevalence of HUA (P<0.05). The prevalence of HUA was higher in hospitalized patients with psychiatric disorders, and the prevalence was inversely proportional to age.

Predictors of transition to schizophrenia and other long-lasting non-affective psychoses in first-episode patients with acute and transient psychotic disorders: A validation study

Background and objectivesAlmost half of the individuals with a first-episode of psychosis who initially meet criteria for acute and transient psychotic disorder (ATPD) will have had a diagnostic revision during their follow-up, mostly toward schizophrenia. This study aimed to determine the proportion of diagnostic transitions to schizophrenia and other long-lasting non-affective psychoses in patients with first-episode ATPD, and to examine the validity of the existing predictors for diagnostic shift in this population. MethodsWe designed a prospective two-year follow-up study for subjects with first-episode ATPD. A multivariate logistic regression analysis was performed to identify independent variables associated with diagnostic transition to persistent non-affective psychoses. This prediction model was built by selecting variables on the basis of clinical knowledge. ResultsSixty-eight patients with a first-episode ATPD completed the study and a diagnostic revision was necessary in 30 subjects at the end of follow-up, of whom 46.7% transited to long-lasting non-affective psychotic disorders. Poor premorbid adjustment and the presence of schizophreniform symptoms at onset of psychosis were the only variables independently significantly associated with diagnostic transition to persistent non-affective psychoses. ConclusionOur findings would enable early identification of those inidividuals with ATPD at most risk for developing long-lasting non-affective psychotic disorders, and who therefore should be targeted for intensive preventive interventions.

Descriptive Epidemiology of Mental Illness and Epilepsy at the Psychiatric Hospital of Bouaké (Ivory Coast)

Mental illness is a public health problem worldwide. As in some African countries, epidemiological data are insufficient in Côte d'Ivoire. After more than ten years of socio- political crisis, an update of the data was necessary for a better psychiatric assistance in the region of Gbêkê strongly impacted during this period. Objective: The objective of this work was to study the mental disorders observed at the Psychiatric Hospital of Bouaké. Materials and method: This was a retrospective study with a descriptive aim, involving 550 files. Results: We noted a predominance of females (51%) residing in Bouaké with an age range between 15 and 34 years (52.9%), mostly single (56.9%). 61.3% of our sample was composed of subjects with a level of education lower than secondary school and who were not in employment (37.5%). As for psychiatric pathologies, depression was the most common (21.6%), followed by acute and transient psychotic disorders (18.4%), then schizophrenia (13.1%) and epilepsy (12.2%). These results prompted a study on the evaluation of the therapeutic management of mental patients at the psychiatric hospital in Bouaké.

A case report of COVID-19-associated severe psychotic symptoms and suicidal behavior: a late psychiatric intervention

A 25-year-old previously healthy female patient experienced new-onset psychosis and showed suicidal behavior after contracting COVID-19. Based on the International Statistical Classification of Diseases and Related Health Problems (ICD-10), the diagnosis of an acute and transient psychotic disorder (ATPD) was appropriate. Due to poor insight into illness, the patient received an oral solution containing 2 mg/mL haloperidol and fully recovered after the first month of treatment. This is the first case of a COVID-19-associated psychotic episode showing full recovery with late intervention, which occurred nearly 45 days after exhibiting the first psychotic symptoms. Additionally, the patient would require long-term follow-up owing to an ultra-high risk of relapse.

Acute and transient psychotic disorders: A review of Indian research.

Acute and transient psychotic disorder (ATPD) was recognized as separate from other psychotic disorders and described in the International Classification of Diseases (ICD) tenth revision for the first time. A lot of research on ATPD has been conducted in India over the last six decades, but a review focusing exclusively on Indian research on ATPD is not available. This paper aims to review the literature on ATPD emerging from India. A combination of search terms "Acute and Transient Psychosis," "acute psychosis," "non-affective psychosis," "non-affective psychotic disorder," "reactive psychosis," "first-episode psychosis," and "India" were searched on various search engines like PUBMED, Medknow, Hinari, and Google Scholar. We also did a hand search for additional relevant articles, including published abstracts of the Indian Journal of Psychiatry from 2007 to 2023. Relevant papers were selected. The prevalence of ATPD varies across different study settings, and it tends to have an abrupt to acute onset, and is primarily associated with stress. Few studies have assessed the subtypes of ATPD, and symptom profile has been inconsistently reported. There is a lack of trials on the effectiveness or efficacy of antipsychotics in ATPD patients. In a large proportion of patients initially diagnosed with ATPD, the diagnosis remains stable, with recurrence varying from 10% to 46.6% based on the duration of follow-up. There is a need for more multicentric studies, studies with larger sample sizes, and consistency in data about risk factors. There is a need to evaluate symptom profile, course, outcome, and treatment outcomes in patients with ATPD using validated instruments to improve our understanding. Further, there is a need for comparative studies to evaluate the risk factors for ATPD.

Стресові реакції у хворих з розладами спектру шизофренії та комплексний підхід в їх лікуванні

Abstract The psychotraumatic factors that occurred during the war of 2022-2023 significantly affect on the onset and dynamics of schizophrenia spectrum disorders (SSD). Objective. To study the relationship between the influence of stress factors in patients with SSD with the dynamics of exacerbation of psychopathological symptoms and to create complex of treatment and rehabilitation (CTR) for these patients. Methods and materials. There was psychopathological examination of 68 patients with different types of SSD who experienced severe stress during the war and assessed the clinical features of theire psychotic state, and the content of stress factors. Results. In the research the largest number were patients with schizophrenia (Sch, 42.6% of cases), most often with paranoid form with progressive paroxysmal course, as well as patients with acute and transient psychotic disorders (APD), schizoaffective disorder (SchAD) and schizotypal disorder (StD). There were diagnosed affective and delusional symptoms (54.4% of cases) most often as the leading psychopathological reaction to the psychotraumatic stress effects in patients with SSD. Only patients with Sch had the highest incidence of hallucinatory-paranoid syndrome (71.4% of cases). The onset or relapse of a psychotic episode among patients with SSD developed as a result of a significant impact of stress factors with different content, but related to the war in all cases. The most frequent of these were difficulties during evacuation, which caused increasing in family conflicts, especially in patients with Sch and StD. It was found the stressful media impact caused an exacerbation of psychotic symptoms in one third of patients with Sch and StD. There was essential psychotraumatic impact to patients with SSD as of the repeated bombing; the death of relatives; fears experienced during the occupation; inability to continue treatment; and psychotraumatic circumstances associated with the loss of work or no money to live. The CTR for patients with SSD who have been significantly affected by stress based on the analysis of the relationship between nosology, clinical symptoms and stress factors. The aim of the CTR is effective treatment of a psychotic episode or reactive psychotic state, should be steady and consist of the following stages: diagnostic; emergency, outpatient and/or inpatient care; psycho-rehabilitation, as well as support and psychoprophylaxis. Its structure should combine the use of psychopharmacotherapy with psychotherapy (psychocorrection) and psychoeducation, followed support of the patient at the stage of remission.

A 15-year comparative follow-up study of adolescent schizophrenia and acute and transient psychotic disorders with onset in adolescence

Aim: Comparative follow-up studies on the course of adolescent schizophrenia, on the one hand, and syndromes diagnosed initially as acute and transient psychotic disorders in adolescence, on the other, are rare in the literature. In our analysis, we compared the course of these syndromes based on selected clinical and social indicators. Materials and methods: A total of 34 patients hospitalised in adolescence (time point 1) for schizophrenia (11 patients) and for acute and transient psychotic disorders (23 patients – both diagnoses according to the ICD-10 criteria) were re-examined 15 years later (time point 2). The assessment was based on a psychiatric examination as well as questionnaires, letters and queries in selected hospitals and psychiatric wards. Results: After 15 years, the respondents in the group with a baseline diagnosis of schizophrenia revealed a significantly higher severity of schizophrenia symptoms, particularly the axial symptoms of the illness, as well as a higher severity of cognitive deficits. They had more frequent and longer psychiatric hospitalisations during the follow-up period, with the difference being more pronounced in the sub-period of the first five years after hospitalisation. These subjects experienced a deeper regression at time point 2, with lower levels of insight and poorer working lives, and were significantly more likely to receive a diagnosis of schizophrenia than patients in the other group. Conclusions: A diagnosis of adolescent schizophrenia proves to be a more significant predictor of the patients’ deteriorated functioning both in terms of clinical and social parameters than a diagnosis of acute and transient psychotic disorders made during the same developmental period.

The impact of substance misuse in patients with first-episode psychosis: a retrospective study

IntroductionSubstance misuse increases the risk of developing psychosis in vulnerable people. However, patients with substance use disorders’ attributes and their effect on first-episode psychosis (FEP) are still unclear.ObjectivesTo describe and compare inpatient admissions for FEP with substance misuse and its impact on clinical outcomes.MethodsWe conducted an observational and retrospective study, analyzing sociodemographic determinants and clinical data regarding the patients hospitalized for FEP, between January 2019 and June 2022, in the psychiatric unit at our hospital in Bragança, Portugal. We used logistic regression to estimate the effect of social determinants and other clinical data regarding the patients hospitalized for FEP with substance abuse.ResultsWe included 78 patients in this study. Of these patients, 30% (n=23) reported substance (drugs or alcohol) misuse prior to hospital admission. Regarding only the patients with substance misuse, 96% were male and the median age was 31 years. Cannabis was the most often reported substance of abuse (83%). Most of these patients were unmarried (OR:10.794; 95%CI:2.855-40.805;P=0.001), lived in a rural setting (OR:0.263; 95%CI:0.094-0.731;P=0.009) and had no previous psychiatric history (OR:1.022; 95%CI:0.386-2.709;P=0.964).Regarding hospital admission, 70% were involuntary admitted (OR:4;95%CI:1.408-11.366;P=0.007) and the median time of hospitalization was 17 days. At the time of discharge, 48% of these set of patients still didn’t have insight into their mental illness (OR:1.737;95%CI:0.646-4.679;P=0.272). During the evaluation period of this study, 13% of the patients were readmitted to the hospital (OR:1.029;95%CI:0.241-4.383;P=0.970) and 35% missed outpatient appointments (OR:3.133;95%CI:1.003-9.791;P=0.044). The diagnoses at the time of discharge were: substance-induced psychosis (52%), schizophrenia (22%), affective psychosis (17%), and acute and transient psychotic disorder (9%).ConclusionsThis analysis indicates substance misuse predates and is prevalent in FEP. Many of these patients fail to recognize and accept that they are suffering from a mental illness and drop out of outpatient psychiatric care. Further, substance-induced psychoses are associated with a significant risk for transition to schizophrenia particularly following cannabis-induced psychosis. Thus, it is crucial to optimize adherence to the therapeutic regimen and outpatient follow-up.Disclosure of InterestNone Declared

Clinical features and outcomes in acute psychosis: A retrospective hospital-based study in rural patients of central India.

Acute and transient psychotic disorder (ATPD) is a distinct diagnostic category (F23) in ICD-10 which includes non-schizophrenic and non-affective psychoses following a transient course. The clinical features, diagnostic stability, and epidemiology of ATPD have not been adequately explored in the developing countries. The aim was to explore the socio-demographic and clinical characteristics of ATPD as well as examine the diagnostic stability and longitudinal revisions in the diagnosis of ATPD. An observational retrospective study based on 10-year OPD records of ATPD patients was conducted in a tertiary health care center after ethics committee approval. A total of 120 patient records were analyzed for socio-demographic data, clinical symptoms, mental status examination findings, diagnosis on the first visit, and subsequent revisions in the diagnosis. The mean age of ATPD patients was 31.8 (±11.73) years. Delusion was the most common psychiatric symptom in ATPD patients followed by abnormal speech, hallucinations, and disorganized behavior. Antecedent psychosocial stressors were found in 44.2% cases. More than half of ATPD patients (51%) followed up after initial symptom remission and were diagnosed with chronic mental illnesses (schizophrenia or bipolar affective disorder). The ATPD patients experiencing a stressor at the onset of illness were less likely to develop chronic mental illness compared to the ones who did not have antecedent stressors. Irrespective of the genetic and phenomenological distinctiveness of ATPD, which has led to its inclusion as a separate diagnostic category in ICD-10, ATPD is an unstable diagnosis.

A study on the pathway to care among patients with first episode psychosis attending a tertiary health care center in North Karnataka

ABSTRACT Context: Early treatment of schizophrenia and other psychotic disorders has a significant impact on the prognosis and outcome of these disorders. To reduce the time of untreated psychosis, it is necessary to know the help-seeking behavior and the path taken by the patients and their caregivers. Efforts at reducing the time to initiate treatment for first-episode psychosis (FEP) are very much needed. The pathway to care helps in determining various factors associated with the delay and also creates awareness regarding the negative pathway determinants. Aim: This study aims to find out the pathway to care in FEP. Settings and Design: This is a hospital-based, time-bound, cross-sectional study, conducted from January to June 2022 in the department of psychiatry of a tertiary health care center in North Karnataka. Subjects and Methods: Basic sociodemographic, clinical, and details related to pathway to care were collected using semi-structured pro forma. MINI plus 5.0.0 and International Classification of Diseases-10 DCR were used to assess and confirm the diagnosis. Brief Psychiatric Rating Scale was used to measure the severity of symptoms. Statistical Analysis: Data were compiled and appropriate statistical tests were used to analyze the data with the help of SPSS version 17.0. Results: Sixty-one cases of FEP were assessed. The majority (44.2%) of the cases were diagnosed with acute and transient psychotic disorders and 16.4% were schizophrenia. The median duration of untreated psychosis was 30 days (15–150 days). For the majority (54.1%) of the patients, first contact was faith healers and for 31.1%, it was mental health facilities. Conclusion: The most common pathway taken by the patients was faith healers as they were easily available in rural areas and free from stigma associated with mental illness. These findings can be utilized in making policies to increase awareness about mental health and also about the availability of mental health services.

Clinical Practice Guidelines for Assessment and Management of Patients with Substance Intoxication Presenting to the Emergency Department.

Clinical Practice Guidelines for Assessment and Management of Patients with Substance Intoxication Presenting to the Emergency Department.

Mapping diagnostic trajectories from the first hospital diagnosis of a psychiatric disorder: a Danish nationwide cohort study using sequence analysis

A key clinical problem in psychiatry is predicting the diagnostic future of patients presenting with psychopathology for the first time. The objective of this study was to establish a comprehensive map of subsequent diagnoses after a first psychiatric hospital diagnosis. Through the Danish National Patient Registry, we identified patients aged 18 years or older with an inpatient or outpatient psychiatric hospital contact and who had received one of the 20 most common first-time psychiatric diagnoses (defined at the ICD-10 two-cipher level, F00-F99) between Jan 1, 1995, and Dec 31, 2008. For each first-time diagnosis, the 20 most frequent subsequent psychiatric diagnoses (F00-F99), and death, occurring during 10 years of follow-up were identified as outcomes. To assess diagnostic stability, we used social sequence analyses, assigning a subsequent diagnosis to each state with a length of 6 months following each first-time diagnosis. The subsequent diagnosis was defined as the last diagnosis given within each 6-month period. We calculated the normalised entropy of each sequence to show the uncertainty of predicting the states in a given sequence. Cox proportional hazards models were used to assess the risk of receiving a subsequent diagnosis (at the one-cipher level, F0-F9) after each first-time diagnosis. The cohort consisted of 184 949 adult patients (77 129 [41·7%] men and 107 820 [58·3%] women, mean age 42·5 years [SD 18·5; range 18 to >100). Ethnicity data were not recorded. Over 10 years of follow-up, 86 804 (46·9%) patients had at least one subsequent diagnosis that differed from their first-time diagnosis. Measured by mean normalised entropy values, persistent delusional disorders (ICD-10 code F22), mental and behavioural disorders due to multiple drug use and use of other psychoactive substances (F19), and acute and transient psychotic disorders (F23) had the highest diagnostic variability, whereas eating disorders (F50) and non-organic sexual dysfunction (F52) had the lowest. The risk of receiving a subsequent diagnosis with a psychiatric disorder from an ICD-10 group different from that of the first-time diagnosis varied substantially among first-time diagnoses. These data provide detailed information on possible diagnostic outcomes after a first-time presentation in a psychiatric hospital. This information could help clinicians to plan relevant follow-up and inform patients and families on the degree of diagnostic uncertainty associated with receiving a first psychiatric hospital diagnosis, as well as likely and unlikely trajectories of diagnostic progression. Mental Health Services, Capital region of Denmark. For the Danish translation of the abstract see Supplementary Materials section.

A case report of COVID-19-associated severe psychotic symptoms and suicidal behavior: a late psychiatric intervention

A 25-year-old previously healthy female patient experienced new-onset psychosis and showed suicidal behavior after contracting COVID-19. Based on the International Statistical Classification of Diseases and Related Health Problems (ICD-10), the diagnosis of an acute and transient psychotic disorder (ATPD) was appropriate. Due to poor insight into illness, the patient received an oral solution containing 2 mg/mL haloperidol and fully recovered after the first month of treatment. This is the first case of a COVID-19-associated psychotic episode showing full recovery with late intervention, which occurred nearly 45 days after exhibiting the first psychotic symptoms. Additionally, the patient would require long-term follow-up owing to an ultra-high risk of relapse.

A Cross-Sectional Study of Psychiatric Comorbidity in Croatian Homeland War Veterans Who Were Held as Prisoners of War and Are Affected by Posttraumatic Stress Disorder.

As a extremely traumatic experience, captivity may cause other mental disorders in addition to posttraumatic stress disorder, which is highly prevalent among ex-prisoners of war, and which often occurs in comorbidity with at least one other mental disorder. This objective of this study is to identify the incidence of comorbid mental disorders in Homeland war veterans ex-prisoners of war affected by posttraumatic stress disorder, as well as to identify the factors that influenced psychiatric comorbidity. The study sample comprised 264 subjects, all of whom were Croatian Homeland War veterans with combat experience in the defence of the Republic of Croatia, and all of whom fulfilled clinical criteria for posttraumatic stress disorder at the time of the study. The subjects were divided into two groups: the experimental group was composed of ex-prisoners of war, and the control group of veterans who had never been prisoners of war. The methods of sociodemographic questionnaire, posttraumatic stress disorder self-report checklist and the Harvard Trauma Questionnaire were used in the study. Psychiatric comorbidity data were retrieved from the subjects' anamnesis and medical records. The results showed that ex-prisoners of war were exposed to a statistically much higher number of traumatic events, and had a significantly higher total number of psychiatric comorbidities (p<0.01) than the control group. The incidence of acute and transient psychotic disorders, generalized anxiety disorders and psychological and behavioural factors associated with disorders or diseases classified elsewhere was significantly higher among ex-prisoners of war. There was no statistically significant difference in overall posttraumatic stress disorder intensity between the two groups (p<0.05). The results of the study confirm our hypothesis that the incidence of psychiatric comorbidity is higher in ex-prisoners of war.

Gender distribution of mental health disorders among adolescents of Togo, West Africa: A hospital-based study

This article describes data on the gender distribution of mental health disorders among adolescents of Togo, West Africa. The sample size of this study included 242 patients. Gender and mental health disorders according to the definition of International Classification of Disease, tenth revision (ICD-10) were considered. Females were significantly more likely to develop a mental health disorder than males (61.16% vs 38.84% of the sample), and females were significantly 3 times more likely to develop Somatoform Disorders- Other Neurotic Disorders compared to males. Males were significantly 2 times more likely to develop Acute and Transient Psychotic Disorders.

Personalized approach to early diagnosis of acute schizophrenia: an observational comparative study

BACKGROUND: An acute schizophrenic episode often meets the diagnostic criteria for the ICD-10 category acute and transient psychotic disorders (ATPD, F23), which includes clinically similar conditions of diverse etiologies. The presence of schizophrenic negative symptoms in ATPD signifies their nosological affiliation and determines the therapeutic tactics. Early recognition of the schizophrenic etiology in the first episode of psychosis may contribute to the development of a personalized approach for the management of patients with acute psychotic disorders.&#x0D; AIM: To evaluate the relationship between the developmental characteristics of psychosis and identify the negative symptoms after its reduction in patients with ATPD with the symptoms of schizophrenia.&#x0D; MATERIALS AND METHODS: This observational single-center selective comparative study was conducted during 20182020. The clinical-psychopathological method was applied to examine patients hospitalized in a psychiatric hospital with ATPD presenting with the symptoms of schizophrenia (F23.1). In order to objectify the results of the study, the positive and negative syndrome scale was used.&#x0D; RESULTS: The study involved 60 patients (50 men, 10 women) aged 1846 years (mean age: 21.46.0 years). Depending on the presence of negative symptoms after the psychosis reduction at 4 weeks of therapy, the study sample was divided into two groups: 1) the group with negative symptoms (NS+; n=41); 2) the group without any negative symptoms (NS; n=19). Individuals presenting with negative symptoms were distinguished from those without it based on the more frequent presence of prodromal disorders, subpsychotic, and, particularly, mild negative disorders at the prodromal stage, prolonged development, and long-drawn course of psychosis. The likelihood of negative symptoms detection after the reduction of psychosis was associated with a family history of schizophrenia and other psychiatric disorders, low premorbid social adjustment, prodromal symptoms, and impaired functioning, as well as with a longer duration of psychotic symptoms and its slow development.&#x0D; CONCLUSION: The likelihood of negative symptoms after the reduction of ATPD with symptoms of schizophrenia was associated with hereditary and premorbid characteristics of patients, prodromal psychopathological and functional abnormalities, as well as the clinical and dynamic characteristics of psychosis. The data obtained from this study may contribute to the early recognition of schizophrenia-spectrum disorders and to the development of a personalized approach for the management of patients with ATPD.

Immune-mediated inflammatory markers in acute and transient psychotic disorders-comparison with schizophrenia: An exploratory comparative study.

Considering Acute and Transient psychotic disorders (ATPDs) to be a close entity to Schizophrenia (SZ) with a completely different course and outcome, studies evaluating the immunological abnormalities are scarce in ATPDs. We analysed immune-mediated inflammatory marker levels [Interleukin-2 (IL-2), Interleukin-4 (IL-4), Interleukin-6 (IL-6), Interleukin-8 (IL-8), Interleukin-17 (IL-17) and Tumour necrosis factor-alpha (TNF-α)] in patients with ATPDs (in the acute phase and after remission), and compared these with patients with SZ in remission and with healthy controls. Ninteen subjects with ATPDs in acute phase of illness were age-/gender-matched with healthy controls and patients with schizophrenia in remission; recruited through purposive sampling. Clinical assessment and immune-marker levels were carried out in all the three groups. Follow -up repeat immune-marker levels assessment in the ATPD group was conducted after remission status was ensured. Immune-marker levels were compared across the three groups. Patients with ATPDs had elevated levels of the pro-inflammatory cytokines IL-6 and IL-17 and low levels of IL-8 in the acute phase and low levels of IL-6 and elevated levels of IL-8 during the remission phase. Compared to patients with SZ in remission, patients with ATPD in remission had low levels of all the three pro-inflammatory cytokines (with significantly low IL-6 levels and non-significant, yet low levels of IL-8 and IL-17) and had significantly low and high levels of IL-6 and IL-8 respectively than healthy controls. These findings suggest that there existed immunological abnormalities in the acute and remission phase of illness in patients with ATPDs compared to both patients with SZ in remission and healthy controls.

Schizophrenia and other primary psychotic disorders in ICD-11: features of the dimensional approach

The latest version of the International Classification of Diseases (ICD-11) was adopted by the 72nd World Health Assembly in 2019 and entered into force on 1 January 2022. A very important step towards the implementation of ICD-11 in Ukraine is the training of specialists, their acquaintance with the possibilities of the new version classification and its diagnostic features. This article begins a series of works devoted to the coverage and interpretation of ICD-11 headings. The main difference between ICD-11 is the use of a dimensional approach, which has completely supplanted the categorical approach (the typological approach on which the previous ICD-10 classification was based). Instead of focusing on the diagnosis of the phenomenological structure and subtypes of the disease, dimensional classification focuses on assessing the dynamics and severity of symptoms that determine the severity of the condition and are key in the rehabilitation and recovery of the patient. The article covers the ICD-11 section on Schizophrenia and other primary psychotic disorders. This article describes the diagnostic categories Schizophrenia (6A20), Schizoaffective Disorder (6A21), Schizotypal Disorder (6A22), Acute and Transient Psychotic Disorder (6A22), Delusional Disorder (6A24) and Symptomatic Primary Psychotic Disorder (6A25).