Filippo Queirazza, MD, MRCPsych, Hairmyres Hospital, East Kilbride, Glasgow; David M. Semple, MB ChB, MRCPsych, Division of Psychiatry, University of Edinburgh, Edinburgh, and Hairmyres Hospital, East Kilbride, Glasgow; Stephen M. Lawrie, MD, FRCPsych, Division of Psychiatry, University of Edinburgh, UK.
Br J Psychiatry. 2014;204:299-305. doi: 10.1192/bjp.bp.113.127340. Epub 2013 Dec 19.
The diagnostic category of acute and transient psychotic disorders (ATPD) was introduced in ICD-10. Subsequent studies have called into question its validity and reliability.
To determine the pattern of diagnostic revision to schizophrenia in first-ever diagnosed ATPD.
Using data drawn from the Scottish Morbidity Record, we estimated incidence and diagnostic change in first-ever diagnosed ATPD in Scottish hospitals between January 1997 and December 2010 (n = 2923).
The average incidence of ATPD was 4.1 per 100 000 population per year. Diagnostic stability was estimated at 53.9% over an average of approximately 4 years of observation. The most common diagnostic shift was to schizophrenia (12.6%), over an average of 1.7 years. Estimates of the transition risks for schizophrenia were 80% at 2.8 years and 90% at 4.6 years. Longer first admission to hospital, younger age at onset and male gender were associated with increased risk and earlier development of schizophrenia.
Routinely collected data suggest that approximately one in eight individuals with first-ever diagnosed ATPD will develop schizophrenia within 3-5 years. Those at high risk of transition may benefit from monitoring for possible diagnostic change.
急性短暂性精神病障碍（ATPD）的诊断类别在 ICD-10 中引入。随后的研究对其有效性和可靠性提出了质疑。
确定首次诊断为 ATPD 的精神分裂症的诊断修订模式。
我们使用来自苏格兰发病率记录的数据，估计了 1997 年 1 月至 2010 年 12 月期间苏格兰医院中首次诊断为 ATPD 的发病率和诊断变化（n=2923）。
ATPD 的平均发病率为每年每 100000 人 4.1 例。在平均约 4 年的观察期内，诊断稳定性估计为 53.9%。最常见的诊断转移是精神分裂症（12.6%），平均时间为 1.7 年。精神分裂症的转换风险估计为 2.8 年内 80%，4.6 年内 90%。首次住院时间较长、发病年龄较小和男性与精神分裂症风险增加和发病较早有关。
常规收集的数据表明，大约每 8 例首次诊断为 ATPD 的患者中就有 1 例将在 3-5 年内发展为精神分裂症。那些有较高转换风险的人可能受益于监测可能的诊断变化。
