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Conceptual Issues in Acute and Transient Psychotic Disorders.

Augusto C Castagnini1, German E Berrios2

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Classification systems for short-lived psychotic disorders show significant divergence, hindering research. This study reveals a lack of continuity between historical and modern diagnostic concepts for these conditions.

Keywords:
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Area of Science:

  • Psychiatry
  • Mental Health Classification
  • Nosology

Background:

  • Current diagnostic systems, including the ICD-11's "acute and transient psychotic disorder" and the DSM-5's "brief psychotic disorder," present divergent classifications for short-lived psychotic disorders.
  • This divergence highlights a significant gap in the understanding and classification of these conditions.

Purpose of the Study:

  • To examine the conceptual issues underlying the development of diagnostic categories for short-lived psychotic disorders.
  • To assess the continuity between historical nosological concepts and current diagnostic classifications.

Main Methods:

  • Conceptual analysis of diagnostic categories for short-lived psychotic disorders.
  • Comparison of historical concepts (e.g., bouffée délirante, cycloid psychosis, reactive psychosis) with modern diagnostic criteria (DSM-5, ICD-11).

Main Results:

  • Little continuity was found between earlier nosological concepts and modern descriptive categories for short-lived psychotic disorders.
  • Shortcomings in symptom completeness, specificity, and heterogeneity were identified in current categories.
  • Changes in definitions and diagnostic criteria across DSM and ICD versions have hampered empirical research.

Conclusions:

  • The current classification of short-lived psychotic disorders suffers from conceptual limitations that impede research progress.
  • Enhanced understanding and greater concordance between diagnostic systems require addressing these nosological shortcomings.