ICD-10 - Acute and Transient Psychotic Disorders
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Other Psychotic Disorders
[From World Health Organization. The ICD-10 Classification of Mental and Behavioural Disorders: Diagnostic Criteria for Research. Copyright, World Health Organization, Geneva, 1993.] ...
G1. There is acute onset of delusions, hallucinations, incomprehensible or incoherent speech, or any combination of these. The time interval between the first appearance of any psychotic symptoms and the presentation of the fully developed disorder should not exceed 2 weeks.
G2. If transient states of perplexity, misidentification, or impairment of attention and concentration are present, they do not fulfill the criteria for organically caused clouding of consciousness as specified for delirium, not induced by alcohol and other psychoactive substances, criterion A.
G3. The disorder does not meet the symptomatic criteria for manic episode, depressive episode, or recurrent depressive disorder.
G4. There is insufficient evidence of recent psychoactive substance use to fulfill the criteria for intoxication, harmful use, dependence, or withdrawal states. The continued moderate and largely unchanged use of alcohol or drugs in amounts or with the frequency to which the individual is accustomed does not necessarily rule out the use of acute and transient psychotic disorders; this must be decided by clinical judgment and the requirements of the research project in question.
G5. Most commonly used exclusion clause. There must be no organic mental disorder or serious metabolic disturbances affecting the central nervous system (this does not include childbirth).
A fifth character should be used to specify whether the acute onset of the disorder is associated with acute stress (occurring 2 weeks or less before evidence of first psychotic symptoms):
Without associated acute stress
With associated acute stress
For research purposes, it is recommended that change of the disorder from a nonpsychotic to a clearly psychotic state is further specified as either abrupt (onset within 48 hours) or acute (onset in more than 48 hours but less than 2 weeks).
Acute polymorphic psychotic disorder without symptoms of schizophrenia
G2. If transient states of perplexity, misidentification, or impairment of attention and concentration are present, they do not fulfill the criteria for organically caused clouding of consciousness as specified for delirium, not induced by alcohol and other psychoactive substances, criterion A.
G3. The disorder does not meet the symptomatic criteria for manic episode, depressive episode, or recurrent depressive disorder.
G4. There is insufficient evidence of recent psychoactive substance use to fulfill the criteria for intoxication, harmful use, dependence, or withdrawal states. The continued moderate and largely unchanged use of alcohol or drugs in amounts or with the frequency to which the individual is accustomed does not necessarily rule out the use of acute and transient psychotic disorders; this must be decided by clinical judgment and the requirements of the research project in question.
G5. Most commonly used exclusion clause. There must be no organic mental disorder or serious metabolic disturbances affecting the central nervous system (this does not include childbirth).
A fifth character should be used to specify whether the acute onset of the disorder is associated with acute stress (occurring 2 weeks or less before evidence of first psychotic symptoms):
Without associated acute stress
With associated acute stress
For research purposes, it is recommended that change of the disorder from a nonpsychotic to a clearly psychotic state is further specified as either abrupt (onset within 48 hours) or acute (onset in more than 48 hours but less than 2 weeks).
Acute polymorphic psychotic disorder without symptoms of schizophrenia
- The general criteria for acute and transient psychotic disorders must be met.
- Symptoms change rapidly in both type and intensity from day to day or within the same day.
- Any type of either hallucinations or delusions occurs, for at least several hours, at any time from the onset of the disorder.
- Symptoms from at least two of the following categories occur at the same time:
- emotional turmoil, characterized by intense feelings of happiness or ecstasy, or overwhelming anxiety or marked irritability;
- perplexity, or misidentification of people or places;
- increased or decreased motility, to a marked degree.
- If any of the symptoms listed for schizophrenia, criterion G(1) and (2), are present, they are present only for a minority of the time from the onset; i.e., criterion B of acute polymorphic psychotic disorder with symptoms of schizophrenia is not fulfilled.
- The total duration of the disorder does not exceed 3 months.
Acute polymorphic psychotic disorder with symptoms of schizophrenia
- Criteria A, B, C, and D of acute polymorphic psychotic disorder must be met.
- Some of the symptoms for schizophrenia must have been present for the majority of the time since the onset of the disorder, although the full criteria need not be met, i.e., at least one of the symptoms in criteria G1(1)a to G1(2)c.
- The symptoms of schizophrenia in criterion B above do not persist for more than 1 month.
Acute schizophrenialike psychotic disorder
- The general criteria for acute and transient psychotic disorders must be met.
- The criteria for schizophrenia are met, with the exception of the criterion for duration.
- The disorder does not meet criteria B, C, and D for acute polymorphic psychotic disorder.
- The total duration of the disorder does not exceed 1 month.
Other acute predominantly delusional psychotic disorders
- The general criteria for acute and transient psychotic disorders must be met.
- Relatively stable delusions and/or hallucinations are present but do not fulfill the symptomatic criteria for schizophrenia.
- The disorder does not meet the criteria for acute polymorphic psychotic disorder.
- The total duration of the disorder does not exceed 3 months.
Other acute and transient psychotic disorders
Any other acute psychotic disorders that are not classifiable under any other category in acute and transient psychotic disorders (such as acute psychotic states in which definite delusions or hallucinations occur but persist for only small proportions of the time) should be coded here. States of undifferentiated excitement should also be coded here if more detailed information about the patient's mental state is not available, provided that there is no evidence of an organic cause.
Acute and transient psychotic disorder, unspecified
Any other acute psychotic disorders that are not classifiable under any other category in acute and transient psychotic disorders (such as acute psychotic states in which definite delusions or hallucinations occur but persist for only small proportions of the time) should be coded here. States of undifferentiated excitement should also be coded here if more detailed information about the patient's mental state is not available, provided that there is no evidence of an organic cause.
Acute and transient psychotic disorder, unspecified
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