F231 Acute polymorphic disorder with symptoms of schizophrenia bouffe dlirante or cycloid psychosis with symptoms of schizophrenia

This diagnostic category combines the symptoms of acute polymorphic psychotic disorder with some typical symptoms of schizophrenia (F20) present for most of the time. However, the schizophrenic symptoms are not precisely listed. F23.1 can be a provisional diagnosis, which is changed to schizophrenia if the criteria of F20 persist more than a month.

Acute polymorphic disorder with symptoms of schizophrenia satisfies the general criteria for acute and transient psychotic disorders:

• acute onset of less than 2 weeks

• polymorphic delusions and hallucinations or perceptual disturbances leading to incomprehensible or incoherent speech

• clouding of consciousness with impairment of attention or concentration, disorientation, perplexity, etc.

• emotional turmoil and affective symptoms (depressed mood, euphoria, anxiety, irritability) without the symptomatic criteria for manic-depressive or recurrent depressive disorders

• rapid changes of the type and intensity of symptoms

• no evidence of causation by organic or psychoactive substances.

It is also associated with some schizophrenic symptoms which are present most of the time:

• mental automatism (thought echo, insertion, withdrawal, or broadcasting)

• control, influence, passivity referred to body movements, thoughts, actions, or sensations

• hallucinations with commentary

• catatonic behaviour

• negative symptoms.

The ICD-10 clinical criteria give no information about psychotic or schizophrenic symptoms or about the action of antipsychotic drugs on these symptoms.

Leonhard(9) described cycloid psychosis as an episode with clouding of consciousness and a marked alteration of thinking. Many authors have reported follow-up studies of cycloid psychoses,(2 2 and 23> which confirm the better prognosis of cycloid psychoses than of schizophrenias and schizoaffective disorders.

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