A comparison of DSM-IV brief psychotic disorder with "positive" schizophrenia and healthy controls

To determine the psychosocial features, course, and outcome of DSM-IV brief psychotic disorder (BPD) in a comparative study, we recruited a cohort of 26 consecutive inpatients fulfilling DSM-IV criteria of BPD as well as a control group with "positive" schizophrenia (PS) and psychiatrically healthy controls matched for age and sex. Demographic and clinical features were systematically evaluated and follow-up investigations were performed at an average of 2.1 years after the index episode or 7.8 years after onset of the disorder using standardized instruments. The index group of 26 cases represented 2.5% of 1,036 patients treated as inpatients for psychotic disorders or major affective episode during the 5-year inclusion period. Eighty-one percent of the BPD patients were female. Indicators of premorbid functioning slightly favored BPD patients. Age at first episode and episode frequency did not differentiate between BPD and PS patients. Relapse was frequent in both groups. At follow-up BPD patients had a significantly more favorable outcome than patients with PS as evidenced by employment, independent living, social role functioning, psychological impairment, and global functioning. As a group, in many respects BPD patients approached the status of psychiatrically healthy controls. DSM-IV BPD is a psychotic disorder of favorable prognosis despite frequent relapse.