Outcomes And Symptom Profile In Acute And Transient Psychosis In A Rural Tertiary Care Centre: One Decade Of Experience.

BACKGROUND AND AIMS: Acute and transient psychotic disorder (ATPD) is a distinct diagnostic category 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 objective of this study was to examine the outcome, symptom profile and sociodemographic correlates in the diagnosis of ATPD. METHODOLOGY: An observational retrospective study based on 10-year OPD records of ATPD patients was conducted in tertiary health care center. A total of 120 patient records were analysed for sociodemographic data, clinical symptoms, mental status examination findings, diagnosis on the first visit and subsequent revisions in the diagnosis. RESULT: The mean age of patients was 31.8 (±11.73) years. Delusion was the most common psychiatric symptom in the patients followed by abnormal speech, hallucinations and disorganized behavior. Antecedent psychosocial stressors were found in 44.2% cases. More than half the patients (51%) returned after initial symptom remission and were diagnosed with chronic mental illnesses (schizophrenia or bipolar affective disorder). The 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 stressor. CONCLUSION: The outcomes of ATPD range from a complete remission following first episode to the development of severe chronic mental illnesses. Hence, irrespective of its genetic and phenomenological distinctiveness, which has led to its inclusion as a separate diagnostic category in ICD-10, ATPD is an unstable diagnosis.