[Two years follow-up of patients with acute psychotic access: evolutionary modes and prognosis]

The aim of this work is to study the evolutionary modes of the acute psychotic access and predictor factors of evolution toward schizophrenia.

It is a prospective survey done at the University Psychiatric Center Ibn Rushd with 2 years of follow-up. The diagnosis was made according to DSM IV criteria by a trained psychiatrist using the Structured Clinical Interview for DSM IV (SCID). All patients answered a pre-established questionnaire inquiring about socio-demographic data and personal and familial antecedent and data about illness. The Positive And Negative Syndrome Scale (PANSS) was used to assess the intensity of symptoms. The social functioning has been evaluated by the Global Assessment of Functioning scale (GAF). Was included every patient with the first episode of acute psychotic access, age between 15 and 50 years old and without psychiatric history. Sixty-five patients were included in this study. Data were missing on 18 subjects, who were not considered further, leaving a sample of 47 patients (29 men, 18 women). The analysis of results was made on the Epi-info software 6.04 (French version).

The mean age of the sample was 23.1 + 7.2 years. A low socio-economic level was found in 91.5% (<200 r). After 2 years of follow-up, a recovery has been recorded in 21.3% of patients and 31.9% developed schizophrenia. A bipolar disorder has been diagnosed in 38.3%. In short, 4 patients (8.5%) relapsed during the first 2 years, presenting another acute psychotic episode. The statistical analysis showed that the evolution toward schizophrenia was bound meaningfully to the male gender, to the young age and to the negative symptom intensity.