[Two-year diagnostic stability and prognosis in acute psychotic episodes]

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.

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.

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.

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.