Psychogenic psychosis revisited: a follow up study

Although brief and acute psychoses are usually dramatic in presentation, they usually have benign course. Studies investigating clinical features and changes in diagnosis between psychotic episodes have differed in design. However, some consistent findings have emerged. This study seeks to clarify and extend these features by describing and comparing clinical diagnostic stability in a group of subjects with first episode psychosis diagnosed as acute psychotic disorder [psychogenic psychosis] followed up for 6 years. The study comprises a retrospective evaluation of case records of 161 patients admitted for the first time with first episode psychosis. Among this group a subgroup of 69 psychogenic psychoses were followed up with special reference to stability of diagnosis within a period of 6 years. Forty-six patients [67.6%] were male, 22 [32.4%] were female and data were missing in one case-record. There was no significant statistical difference between gender and diagnosis. The mean age was 27.5 years [13-45 years]. There were criteria, which distinguish acute psychotic disorder [psychogenic psychosis]. These criteria include acute onset with short duration of untreated psychosis, precipitating factors, adjusted pre-morbid personality, no family history of mental disorder, short duration of admission, full recovery in most of cases, with no further admission. Nearly 80% of the patients have never been admitted again in 6 years time. Our findings show a high level of agreement with the original concept of psychogenic psychosis; however, these bear little relationship to the DSM-IV [1994] and ICD-10 [WHO, 1993] criteria for brief or acute psychotic disorder

Clinical characteristics of first episode psychosis: a retrospective study in AL Ain, United Arab Emirates

The primary aim of this work was to examine the socio-demographic, clinical correlates, the effect of medical treatment on the first episode psychosis in an Arabic country. A retrospective case note review, looking at first episode psychosis who were admitted to the in-patient psychiatric ward in Al Ain general hospital over 5 years. 161 patients with first episode psychosis were reviewed. In the 5-year period under the study, 161 aged 13-45 years with history of first episode psychosis were admitted to the psychiatric ward. They established a different clinical diagnoses according to ICD 10: 69 patients [42.9%] had a diagnosis of acute psychotic episode, 35 patients [21.7%] had a diagnosis of manic episode, 31 patients [19.3%] had a diagnosis of schizophrenia, 16 [9.9%] had depression with psychotic symptoms, 3 [1.9%] drug dependence, 1 [0.6%] persistent delusional disorder, and in 6 [3.7%] patients the data were missing. The mean age was 27.5 years [13-45 years] [SD=6.6], male/female ratio [1 10/49, 68.3%/30.4%]. There was a significant relationship between duration of untreated psychosis [DUP] and outcome, where the longer the DUP the more existence of residual symptoms on discharge [chi 2 =18.515, df=6, p=. 005]. In addition there was a significant relationship between social withdrawal symptom prior to admission and residual symptoms on discharge. Results of this study indicate that DUP, clinical features and type of medications may determine the outcome of first episode psychosis