Extended Diagnostic Evaluation and Neuropsychiatric Characteristics in Acute and Transient Psychotic Disorders – A Descriptive Analysis

Background and Objectives: Acute and transient psychotic disorders (ATPDs) constitute a frequent reason for acute hospitalization. The aim of this study was 1) to describe the value of an extended diagnostic evaluation program for first episode ATPDs and 2) to describe the short-term prognosis of transitioning to schizophrenia or affective disorder in relation to the initial symptom profile. Methods: We collected medical record data from patients with consent, aged 18-65 years, and admitted due to ATPDs (ICD-10: F23.X) to an emergency psychiatry department in Copenhagen, Denmark. The extension of the diagnostic evaluation program included magnetic resonance imaging (MRI), examination of cerebrospinal fluid by lumbar puncture (LBP), and electroencephalography (EEG) if clinically indicated. Results: A total of 53 patients were included. Twenty-nine (55%) were men, the mean age was 25.56 years (SD = 10.71), and the mean length of hospitalization was 32.74 days (SD = 15.39). Clinical evaluations using MRI, LBP, and EEG did not reveal abnormal findings of diagnostic significance. The clinical symptom profile was diverse but could broadly be classified as polymorphic, schizophrenia-like, or unspecified. A pattern towards short-term transitioning to affective disorder was observed among patients who initially presented with fluctuating moods. The majority of patients (53%) maintained their initial diagnosis of ATPD upon discharge. Conclusions: The extended evaluation program was not of additional diagnostic value in this sample of patients with ATPDs. We observed a diverse clinical symptom profile and described patterns that were suggestive of short-term prognosis. However, further research with larger sample sizes and extended follow-up periods is needed to confirm and expand these results.