Am J Psychiatry 1995; 152:1743-1748
Copyright © 1995 by American Psychiatric Association
Epidemiology, diagnosis, and course of brief psychoses
E Susser, S Fennig, L Jandorf, X Amador and E Bromet
New York State Psychiatric Institute, NY 10032, USA.
OBJECTIVE: This study investigated acute and nonacute brief psychoses. On
the basis of previous work, the authors proposed that 1) acute brief
psychoses occur predominantly in females, 2) they often do not conform to
the diagnoses of DSM-III-R, 3) they are temporally stable, and 4) nonacute
brief psychoses do not share these distinctive features. METHOD: The data
are from a follow-up study of 221 first-admission patients with affective
and nonaffective psychoses. Patients were given extensive assessments at
initial evaluation, 6-month follow-up, and 24- month follow-up. The
research team made consensus ratings of the presence of psychosis,
DSM-III-R diagnosis, mode of onset of disorder, and course of disorder.
Brief psychoses were defined by a diagnosis of nonaffective psychosis at
the initial evaluation and a rating of full remission at 6-month follow-up;
acute brief psychoses met the additional criterion of acute onset as
defined by ICD-10. RESULTS: Twenty (9%) of the 221 psychoses were brief
psychoses. Only seven (3%) were acute brief psychoses, but among these, six
occurred in women, five were undiagnosable, and none had evolved into an
affective disorder or a chronic disorder by the time of the 24-month
follow-up. The 13 nonacute brief psychoses did not exhibit distinctive
features, and five of them later evolved into chronic disorders.
CONCLUSIONS: Acute brief psychoses emerged as a highly distinctive and
temporally stable form of psychosis that may merit a separate diagnostic
classification. The more numerous nonacute brief psychoses may represent
mild forms of nonaffective psychoses such as schizophrenia.
