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European Journal of Psychiatry
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Inicio European Journal of Psychiatry Predictors of transition to schizophrenia and other long-lasting non-affective p...
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Vol. 38. Issue 2.
(April - June 2024)
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Vol. 38. Issue 2.
(April - June 2024)
Original article
Predictors of transition to schizophrenia and other long-lasting non-affective psychoses in first-episode patients with acute and transient psychotic disorders: A validation study
Álvaro López-Díaza,b,c,d,
Corresponding author
alvaro.lopez.diaz.sspa@juntadeandalucia.es

Corresponding author at: Mental Health Clinical Management Unit, Virgen Macarena University Hospital, Seville Biomedical Research Centre (IBiS), Spanish Network for Research in Mental Health, Carlos III Institute (CIBERSAM, ISCIII), Department of Psychiatry, School of Medicine, University of Seville, Avda. Dr. Fedriani, 3, 41009, Seville. Spain.
, José Luis Fernández-Gonzáleze, Ignacio Laraa, Benedicto Crespo-Facorrob,c,d,f, Miguel Ruiz-Veguillab,c,d,f
a Mental Health Clinical Management Unit, Virgen Macarena University Hospital, Seville, Spain
b Seville Biomedical Research Centre (IBiS), Seville, Spain
c Spanish Network for Research in Mental Health, Carlos III Institute (CIBERSAM, ISCIII), Spain
d Department of Psychiatry, School of Medicine, University of Seville, Spain
e Mental Health Clinical Management Unit, San Juan de la Cruz Hospital, Úbeda, Spain
f Mental Health Clinical Management Unit, Virgen del Rocío University Hospital, Seville, Spain
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Figures (1)
Tables (3)
Table 1. Sociodemographic and clinical characteristics.
Table 2. Results of univariate analysis for each candidate predictor: Unadjusted between-group comparisons.
Table 3. Predictors of diagnostic transition to schizophrenia and other long-lasting non-affective psychotic disorders: results of multivariate logistic regression analysis a.
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Abstract
Background and objectives

Almost half of the individuals with a first-episode of psychosis who initially meet criteria for acute and transient psychotic disorder (ATPD) will have had a diagnostic revision during their follow-up, mostly toward schizophrenia. This study aimed to determine the proportion of diagnostic transitions to schizophrenia and other long-lasting non-affective psychoses in patients with first-episode ATPD, and to examine the validity of the existing predictors for diagnostic shift in this population.

Methods

We designed a prospective two-year follow-up study for subjects with first-episode ATPD. A multivariate logistic regression analysis was performed to identify independent variables associated with diagnostic transition to persistent non-affective psychoses. This prediction model was built by selecting variables on the basis of clinical knowledge.

Results

Sixty-eight patients with a first-episode ATPD completed the study and a diagnostic revision was necessary in 30 subjects at the end of follow-up, of whom 46.7% transited to long-lasting non-affective psychotic disorders. Poor premorbid adjustment and the presence of schizophreniform symptoms at onset of psychosis were the only variables independently significantly associated with diagnostic transition to persistent non-affective psychoses.

Conclusion

Our findings would enable early identification of those inidividuals with ATPD at most risk for developing long-lasting non-affective psychotic disorders, and who therefore should be targeted for intensive preventive interventions.

Keywords:
Acute and transient psychotic disorder
Brief psychotic disorder
First- episode psychosis
Schizophrenia
Non-affective psychosis

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