[Two-year diagnostic stability and prognosis in acute psychotic episodes]. / Estabilidad diagnóstica y pronóstico a dos años de episodios psicóticos agudos.

INTRODUCTION: The term acute psychosis represents a group of rapid-onset and recovery psychosis. The current diagnostic criteria are not uniform and represent a heterogeneous set of psychoses. Although their form of clinical presentation may be similar, their evolution and prognosis are very different. It is very important to detect the possible factors of chronicity in order to make an early intervention and thus to diminish the negative consequences of the disease. METHODOLOGY: We conducted a 2 year prospective study in 48 patients diagnosed with acute psychosis in their first admission. Data was collected on the evolution and follow-up of the patient in the Mental Health Unit and the sociodemographic and clinical factors of the psychotic index episode that could predict a change in the diagnosis during the two years follow-up were analyzed. RESULTS: None of the sociodemographic or clinical variables studied could predict a change in the diagnosis, except for the presence of a control delusion during the index episode. The diagnosis of schizophreniform or not otherwise specified psychotic disorders predicts an evolution towards schizophrenia or affective psychosis while a brief or substance-induced psychotic episode has a better prognosis, with a tendency to maintain the same diagnosis in the 2 years of follow-up. CONCLUSION: After 2 years of follow-up, an significant number of the patients initially diagnosed of acute psychosis evolved towards a diagnosis of schizophrenia or affective psychosis in a difficult-to-predict way.

Estabilidad diagnóstica y pronóstico a 2 años de episodios psicóticos agudos / Two-year diagnostic stability and prognosis in acute psychotic episodes

Introducción. El término psicosis aguda representa un grupo de psicosis de inicio y resolución rápida. Los criterios diagnósticos actuales adolecen de uniformidad, representando un conjunto heterogéneo de psicosis. Aunque la forma de presentación clínica puede ser similar, la evolución y el pronóstico pueden ser muy diferentes. La detección de posibles factores de riesgo de cronicidad es de especial importancia, pudiendo realizar una intervención precoz y así minimizar las consecuencias negativas de la enfermedad. Metodología. Estudio prospectivo a 2 años de una muestra final de 48 pacientes diagnosticados de psicosis aguda en el ingreso. Se recoge información sobre la evolución y seguimiento del paciente en la Unidad de Salud Mental y analizan los factores sociodemográficos y clínicos del episodio psicótico índice, que puedan predecir un cambio en el diagnóstico durante el período de estudio. Resultados. Ninguna de las variables sociodemográficas o clínicas estudiadas presenta capacidad de predecir un cambio en el diagnóstico, salvo la presencia de un delirio de control durante el episodio índice. El diagnóstico de trastorno esquizofreniformeo psicótico no especificado pronostica una evolución hacia esquizofrenia o psicosis afectiva, mientras el trastorno psicótico breve o inducido por sustancias presentan un mejor pronóstico, tendiendo a mantener el mismo diagnóstico a los 2 años. Conclusión. A los 2 años, de una forma difícilmente predecible, una fracción importante de los pacientes diagnosticados inicialmente de psicosis aguda evoluciona hacia un diagnóstico de esquizofrenia o psicosis afectiva (AU)

Introduction. The term acute psychosis represents a group of rapid-onset and recovery psychosis. The current diagnostic criteria are not uniform and represent a heterogeneous set of psychoses. Although their form of clinical presentation may be similar, their evolution and prognosis are very different. It is very important to detect the possible factors of chronicity in order to make an early intervention and thus to diminish the negative consequences of the disease. Methodology. We conducted a 2 year prospective study in 48 patients diagnosed with acute psychosis in their first admission. Data was collected on the evolution and follow-up of the patient in the Mental Health Unit and the sociodemographic and clinical factors of the psychotic index episode that could predict a change in the diagnosis during the two years follow-up were analyzed. Results. None of the sociodemographic or clinical variables studied could predict a change in the diagnosis, except for the presence of a control delusion during the index episode. The diagnosis of schizophreniform or not otherwise specified psychotic disorders predicts an evolution towards schizophrenia or affective psychosis while a brief or substance-induced psychotic episode has a better prognosis, with a tendency to maintain the same diagnosis in the 2 years of follow-up. Conclusion. After 2 years of follow-up, an significant number of the patients initially diagnosed of acute psychosis evolved towards a diagnosis of schizophrenia or affective psychosis in a difficult-to-predict way (AU)