Predictors of diagnostic stability in brief psychotic disorders: Findings from a 3‐year longitudinal study

Abstract

Introduction Brief psychotic disorder (BPD) is a relatively uncommon and underexplored psychotic condition. Even though BPD has been related to a more favorable outcome than other schizophrenia spectrum disorders (SSD), current knowledge of its predictive factors remains scant. This study aimed to examine its prevalence and find early predictors of BPD diagnostic stability. Methods SSD diagnosis following Diagnostic and Statistical Manual of Mental Disorders (DSM‐IV) criteria was explored in a large epidemiological cohort (n = 569) of non‐affective first‐episode psychosis (FEP) patients enrolled in a three‐year longitudinal intervention program (PAFIP). Premorbid, sociodemographic, and clinical information was collected to characterize BPD patients and determine factors predictive of diagnostic stability. Multivariate analysis included predictors selected from clinical knowledge and also those that had achieved marginal significance (p ≤ 0.1) in univariate analysis. Results A total of 59 patients enrolled in the PAFIP program (10.4% of the whole cohort) met DSM‐IV criteria for BPD, of whom 40 completed the three‐year follow‐up. The temporal stability of BPD in our sample was as high as 40% (n = 16). Transition from BPD to schizophrenia occurred in 37% (n = 15) of patients. Fewer hallucinations at baseline and better insight independently significantly predicted BPD diagnostic stability over time. Conclusion Our findings confirm that BPD is a clinical condition with moderate‐to‐low temporal stability and demonstrate that approximately two‐thirds of FEP individuals experiencing BPD will develop a long‐lasting psychotic disorder during follow‐up, mainly schizophrenia.

Treatment effects of adjunct group music therapy in inpatients with chronic schizophrenia: a systematic review

“…It was considered whether to include acute schizophrenia as a subgroup. A recent 3-year longitudinal study reported that only 37% of BPD transitioned to schizophrenia; psychotic symptoms were mainly psychosis or positive symptoms and sometimes neurological dysfunction and biological lesions related to substance abuse were reported ( 42 ). Furthermore, with the risk of self-harm or suicidal ideation, higher non-adherence, and discontinuation of antipsychotic treatments in patients with acute schizophrenia, the individual might not be sufficiently stabilized in these vulnerable populations and may not be ready for group therapies ( 43 ).…”

Short-term disengagement from early intervention service for first-episode psychosis: findings from the “Parma Early Psychosis” program

“…An additional robust predictor in this investigation was the presence of brief psychotic disorder or schizophreniform disorder at entry. In this respect, drop-out rates of up to 32% were found in FEP patients with brief psychotic disorder [ 84 ], who also often do not engage well with individual psychotherapy for psychosis and, therefore, have unmet clinical needs that are not being adequately addressed by current mental healthcare services [ 85 ]. Our findings seem to suggest less intensive efforts in engagement or less willingness to take on those FEP patients with a diagnosis of brief psychotic disorder or schizophreniform disorder [ 85 , 86 ].…”

Processing speed in first episode of psychosis and first-degree relatives: A candidate endophenotype of spectrum schizophrenia disorders.

“…This speed dependence could explain the differences in PS between groups, such that observed in the brief psychotic disorder subgroup, in which the PS deficits are attenuated or compensated with other cognitive domains. Brief psychotic disorder, considered as a less severe diagnosis, had better performance in PS than those with other diagnoses within SSDs (Ayesa-Arriola et al, 2016;Lo ´pez-Díaz et al, 2021). They also had a better recovery and prognosis, suggesting that PS could be exerting some kind of influence.…”