First-episode acute and transient psychotic disorder in Latvia: a 6-year follow-up study

Acute and transient psychotic disorder (ATPD; F23, ICD-10) is an acute, short-lived psychosis, which has variable prevalence worldwide and has not been extensively studied.

To explore the first episode of ATPD in patients in Latvia by describing the clinical features, analyzing the longitudinal changes of diagnosis and associated socio-demographic characteristics.

Retrospective chart review of all first-time hospitalized patients fulfilling the ICD-10 criteria for ATPD treated at the Riga Centre of Psychiatry and Addiction Disorders, Latvia, during a 3-year period. Patients were followed-up and assessed using standardized instruments.

During a 3-year period, 294 patients were first-time hospitalized with a ATPD diagnosis; 54% were women. The average age at first psychotic episode was 35.7 ± 12.3 years for women, and 30.0 ± 10.8 years for men (P < 0.0001). Over an average of 5.6 years follow-up period, 51% of patients were not re-hospitalized. Later diagnosis was changed to schizophrenia in 73% of the re-hospitalized patients, mostly within the first 2 years of illness. The overall stability rate of ATPD diagnosis reached 58%. Typical polymorphic symptomatology, abrupt onset (i.e. within 48 h), less frequent anxiety, but more frequent hallucinations were observed in ATPD patients that later developed schizophrenia (P < 0.05). Stressful life events in the 6 months prior to the first episode were found in 44% of patients.

Combining these assessments from first-episode ATPD patients in Latvia, with data from other countries may help to predict the development of disease and provide the possible basis for potential changes to ICD-11.