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Variations in incidence and age of onset of acute and transient psychotic disorders

Abstract

Purpose

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).

Methods

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.

Results

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.

Conclusion

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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Acknowledgments

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.

Ethical issues

Data comply with appropriate protection for anonymity, and no ethical approval for this study was required.

Author information

Correspondence to Augusto Castagnini.

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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

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Keywords

  • ATPDs
  • Brief psychotic disorder
  • Epidemiology
  • ICD-10
  • Polymorphic psychotic disorder