# Diagnostic Stability of Acute and Transient Psychotic Disorders at a Tertiary Care Center: A Retrospective Record-Based Study

## TL;DR

This study examines how stable the diagnosis of acute and transient psychotic disorders is over one year in an Indian hospital, finding that it decreases significantly over time.

## Contribution

The study provides new insights into diagnostic stability of ATPD in a developing country context using a one-year follow-up.

## Key findings

- Diagnostic stability of ATPD dropped from 59.25% at six months to 40.74% after one year.
- Schizophrenia and bipolar disorder were the main alternative diagnoses after the initial ATPD diagnosis.
- Results suggest the need for long-term follow-up and improved diagnostic practices for ATPD.

## Abstract

Background

Acute and transient psychotic disorders (ATPD) have been a diagnostic enigma due to their fleeting nature. While classified in various systems, discrepancies continue between the WHO's International Classification of Diseases, 10th Edition (ICD-10), International Classification of Diseases, 11th Edition (ICD-11), and Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). Research on ATPD, especially in developing countries like India, is scarce, leading to uncertainty about their prevalence and diagnostic stability.

Aim and objective

This study aims to investigate the stability of ATPD diagnoses over a period of one year in an Indian context.

Methods

A retrospective study conducted at a tertiary care center examined the diagnostic stability of ATPD. Fifty-four patients diagnosed with ATPD between January and June 2022 were identified from outpatient records. Their medical history, including age, sex, symptom onset, duration, stressors, and family history, was analyzed. Additionally, follow-up diagnoses at six months and one year were assessed to determine how often the initial ATPD diagnosis changed. Data analysis employed tools like Microsoft Excel (Microsoft Corporation, Redmond, Washington, United States) and IBM SPSS Statistics for Windows, Version 26.0 (Released 2019; IBM Corp., Armonk, New York, United States).

Results

Most patients diagnosed with ATPD were young women. Initially, at six months, the diagnostic stability was 59.25%, but this dropped to 40.74% after a year which was significant with a p-value of 0.031. Schizophrenia became the main alternative diagnosis, with bipolar disorder also increasing significantly over time.

Conclusions

While results showed higher initial stability than reported in developed countries, this stability significantly decreased within a year. Diagnostic shifts primarily led to schizophrenia or bipolar affective disorder. These findings suggest long-term follow-up is crucial for accurate prognosis and underscores the need for further research with larger samples and improved designs to refine diagnostic practices for ATPD.