Psych Vivas · General adult psychiatry — psychotic disorders
Schizophreniform and brief psychotic disorder — structured clinical viva
Fellowship viva on brief vs schizophreniform vs schizophrenia thresholds, good prognostic features, ATPD concept, FEP treatment, and careful prognostic communication.
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Interpretation
Reveal interpretationShowHide
Working diagnosis. At 12 days, with abrupt onset after marked stressor and good premorbid function, the best DSM-facing working label is brief psychotic disorder (with marked stressor) — provisional until the episode fully remits within 1 month or the clock forces a longer label. Schizophrenia is premature. If symptoms continue past 1 month without yet reaching 6 months, revise toward schizophreniform. ICD framing may use ATPD language depending on the system specified.[1][2][4]
Good features. Abrupt onset, stressor colour, perplexity, non-blunted affect, good premorbid function — hopeful modifiers, not a reason to stop care.[1]
References6ShowHide
- [1]Nugent KL, Paksarian D, Mojtabai R Nonaffective acute psychoses: uncertainties on the way to DSM-V and ICD-11 Curr Psychiatry Rep, 2011.PMID 21344285
- [2]Castagnini A, Bertelsen A, Berrios GE Incidence and diagnostic stability of ICD-10 acute and transient psychotic disorders Compr Psychiatry, 2008.PMID 18396184
- [3]Galletly C, Castle D, Dark F, et al. Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for the management of schizophrenia and related disorders Aust N Z J Psychiatry, 2016.PMID 27106681
- [4]Provenzani U, Salazar de Pablo G, Arribas M, et al. Clinical outcomes in brief psychotic episodes: a systematic review and meta-analysis Epidemiol Psychiatr Sci, 2021.PMID 35698876
- [5]Castagnini A, Foldager L, Bertelsen A Long-term stability of acute and transient psychotic disorders Eur Arch Psychiatry Clin Neurosci, 2013.PMID 23028179
- [6]Kahn RS, Fleischhacker WW, Boter H, et al. Effectiveness of antipsychotic drugs in first-episode schizophrenia and schizophreniform disorder Lancet, 2008.PMID 18374841