To determine incidence and age of onset of the ICD-10 category of ‘acute and transient psychotic disorders’ (ATPDs) characterised by subtypes with polymorphic, schizophrenic and predominantly delusional symptoms, pointing out differences from schizophrenia (SZ) and bipolar affective disorder (BD).
We identified all subjects aged 15–64 years who were listed for the first time in the Danish Psychiatric Register with a diagnosis of ATPDs (n = 3,350), SZ (n = 4,576) and BD (n = 3,200) in 1995–2008. Incidence rates and rate ratios (IRR; 95 % confidence interval) by gender and age were calculated.
The incidence of ATPDs was 6.7 per 100,000 person-years, similarly high for both genders (IRR 1.0; 0.9–1.1). Among the ATPD subtypes, polymorphic psychotic disorder was more common in females (IRR 1.4; 1.2–1.6) as opposed to those featuring schizophrenic symptoms, which tended to occur in younger males (IRR 1.4; 1.2–1.7). No significant gender difference was found for acute predominantly delusional disorder (IRR 1.0; 0.9–1.2), which had a later onset than any ATPD subtypes. SZ had an incidence twice as high in males (IRR 2.0; 1.9–2.2), and an earlier age of onset than ATPDs. A different pattern was observed for BD in terms of a slightly greater incidence in females (IRR 1.1; 1.0–1.1), and a later age of onset than both ATPDs and SZ.
These findings are likely to reflect the heterogeneity of the clinical features encompassed by ATPDs, and contribute to building a case for their revision in ICD-11.
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Cooper JE, Jablensky A, Sartorius N (1999) WHO collaborative studies on acute psychoses using the SCAAPS schedule. In: Stefanis CN, Rabavilas AD, Soldatos CR (eds) Psychiatry: a world perspective, vol 1. Excerpta Medica, Amsterdam, pp 185–192
World Health Organization (1992) The ICD-10 classification of mental and behavioural disorders, clinical descriptions and diagnostic guidelines. World Health Organization, Geneva
American Psychiatric Association (1994) Diagnostic and statistical manual of mental disorders (DSM-IV), 4th edn. American Psychiatric Association, Washington DC
Nugent KL, Paksarian D, Mojtabai R (2011) Nonaffective acute remitting psychoses: uncertainties on the way to DSM-V and ICD-11. Cur Psychiatry Rep 13:203–210
Jørgensen P, Bennedsen B, Christensen J, Hyllested A (1997) Acute and transient psychotic disorder: a 1-year follow-up study. Acta Psychiatr Scand 96:150–154
Singh SP, Burns T, Amin S, Jones PB, Harrison G (2004) Acute and transient psychotic disorders: precursors, epidemiology, course and outcome. Br J Psychiatry 185:452–459
Pillmann F, Marneros A (2005) Longitudinal follow-up in acute and transient psychotic disorders and schizophrenia. Br J Psychiatry 187:286–287
Aadamsoo K, Saluveer E, Küünarpuu H, Vasar V, Maron E (2011) Diagnostic stability over 2 years in patients with acute and transient psychotic disorders. Nord J Psychiatry 65:381–388
Salvatore P, Baldessarini RJ, Tohen M et al (2011) McLean-Harvard International First-Episode Project: two-year stability of ICD-10 diagnoses in 500 first-episode psychotic disorder patients. J Clin Psychiatry 72:183–193
Castagnini A, Foldager L, Bertelsen A (2013) Long-term stability of acute and transient psychotic disorders. Aust N Z J Psychiatry 47:59–64
Rusaka M, Rancāns E (2013) First-episode acute and transient psychotic disorder in Latvia: a 6 years follow-up study. Nord J Psychiatry. doi:10.3109/08039488.2012.761726
Castagnini A, Berrios GE (2011) Acute transient psychoses and their differentiation from schizophrenia. Cur Psychiatry Rev 7:248–255
Mors O, Perto GP, Mortensen PB (2011) The Danish psychiatric central research register. Scand J Public Health 39(suppl. 7):54–57
Kirkbride JB, Fearon P, Morgan C et al (2006) Heterogeneity in incidence rates of schizophrenia and other psychotic syndromes: findings from the 3-center ÆSOP study. Arch Gen Psychiatry 63:250–258
Thorup A, Waltorf BL, Pedersen CB, Mortensen PB, Nordentoft M (2007) Young males have a higher risk of developing schizophrenia: a Danish register study. Psychol Med 37:479–484
Kennedy N, Boydell J, Kalidindi S et al (2005) Gender difference in incidence and age at onset of mania and bipolar disorder over a 35-year period in Camberwell, England. Am J Psychiatry 162:257–262
Castagnini A, Bertelsen A, Berrios GE (2008) Incidence and diagnostic stability of ICD-10 acute and transient psychotic disorders. Compr Psychiatry 49:255–261
Reay R, Mitford E, McCabe K, Paxton R, Turkington D (2009) Incidence and diagnostic diversity in first-episode psychosis. Acta Psychiatr Scand 121:315–319
Susser E, Wanderling J (1994) Epidemiology of nonaffective acute remitting psychosis vs schizophrenia. Sex and sociocultural setting. Arch Gen Psychiatry 51:294–301
Mojtabai R, Varma VK, Susser E (2000) Duration of remitting psychoses with acute onset: implications for ICD-10. Br J Psychiatry 176:576–580
Magnan V (1887) Leçon cliniques sur les maladies mentales. Delahaye & Lecrosnier, Paris
Kleist K (1928) Über zykloide und epileptoide Psychosen und über die Frage der Degenerationspsychosen. Schw Arch Neurol Psychiatr 23:3–37 (Cycloid, paranoid and epileptoid psychoses and the problem of degenerative psychoses. In: Hirsh RS, Shepherd M (eds) Themes and variations in European Psychiatry. Wright, Bristol, 1974, p 297–331)
Leonhard K (1957) Aufteilung der endogenen Psychosen (The classification of endogenous psychoses, Irvington, New York, 1979). Akademie-Verlag, Jena
Castagnini AC, Laursen TM, Mortensen PB, Bertelsen A (2013) Family psychiatric morbidity of acute and transient psychotic disorders and their relationship to schizophrenia and bipolar disorder. Psychol Med. doi:10.1017/S0033291713000044
Das SK, Malhotra S, Basu D (1999) Family study of acute and transient psychotic disorders: comparison with schizophrenia. Soc Psychiatry Psychiatr Epidemiol 34:328–332
Linden SC, Harris M, Whitaker C, Healy D (2009) Religion and psychosis: the effect of the Welsh religious revival in 1904–1905. Psychol Med 40:1317–1323
Sajith SG, Chandrasekaran R, Sadanandan Unni KE, Sahai A (2002) Acute polymorphic psychotic disorder: diagnostic stability over 3 years. Acta Psychiatr Scand 105:104–109
Sartorius N, Üstun TB, Korten A, Cooper JE, van Drimmelen J (1995) Progress toward achieving a common language in psychiatry, II: results from the international field trials of the ICD-10 diagnostic criteria for research for mental and behavioural disorders. Am J Psychiatry 152:1427–1437
Gaebel W (2012) Status of psychotic disorders in ICD-11. Schizophr Bull 38:895–898
Castagnini A, Bertelsen A (2011) Mortality and causes of deaths of acute and transient psychotic disorders. Soc Psychiatry Psychiatr Epidemiol 46:1013–1017
Castagnini A, Foldager L, Bertelsen A (2013) Excess mortality of acute and transient psychotic disorders comparison with bipolar affective disorder and schizophrenia. Acta Psychiatr Scand. doi:10.1111/acps.12077
Kessing LV (1998) A comparison of ICD-8 and ICD-10 diagnoses of affective disorder: a case register-based study from Denmark. Eur Psychiatry 13:342–345
Jakobsen KD, Frederiksen JN, Hansen T, Jansson LB, Parnas J, Werge T (2005) Reliability of clinical ICD-10 schizophrenia diagnosis. Nord J Psychiatry 59:209–212
Kørner A, Lopez AG, Andersen PK, Kessing LV (2009) Acute and transient psychoses in old age and the subsequent risk of dementia: a nationwide register-based study. Geriatr Gerontol Int 9:62–68
Castagnini AC (2010) Wimmer’s concept of psychogenic psychosis revised. Hist Psychiatry 21:54–66
Thanks are due to Mrs G. Pilgaard Perto, programmer of the DPCR, for assistance with data collection.
Conflict of interest
The authors declare that they have no conflict of interest.
Data comply with appropriate protection for anonymity, and no ethical approval for this study was required.
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Castagnini, A., Foldager, L. Variations in incidence and age of onset of acute and transient psychotic disorders. Soc Psychiatry Psychiatr Epidemiol 48, 1917–1922 (2013). https://doi.org/10.1007/s00127-013-0726-7
- Brief psychotic disorder
- Polymorphic psychotic disorder