Diagnostic validity of ICD-10 acute and transient psychotic disorders and DSM-5 brief psychotic disorder

摘要

Background: Short-lived psychotic disorders are currently classified under “acute and transient psychotic disorders” (ATPDs) in ICD-10, and “brief psychotic disorder” (BPD) in DSM-5. This study's aim is to review the literature and address the validity of ATPDs and BPD. Method: Papers published between January 1993 and December 2016 were identified through searches in Web of Science. Reference lists in the located papers provided further sources. Results: A total of 295 articles were found and 100 were selected for inclusion in the review. There were only a few studies about the epidemiology, vulnerability factors, neurobiological correlates and treatment of these disorders, particularly BPD was seldom a specific topic of investigation. Existing studies suggest that short-lived psychotic disorders are rare conditions and more often affect women in early to middle adulthood. They also are neither associated with premorbid dysfunctions nor characteristic family predisposition, while there seems to be greater evidence of environmental factors particularly in developing countries and migrant populations. Follow-up studies report a favourable clinical and functional outcome, but case identification has proved difficult owing to high rates of transition mainly either to schizophrenia or, to a lesser extent, affective disorders over the short- and longer-terms. Conclusions: Although the lack of neurobiological findings and little predictive power argue against the validity of the above diagnostic categories, it is important that they are kept apart from longer-lasting psychotic disorders both for clinical practice and research. Close overlap between ATPDs and BPD could enhance the understanding of these conditions.