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Chapter V

Acute and transient psychotic disorders - F23


A heterogeneous group of disorders characterized by the acute onset of psychotic symptoms such as delusions, hallucinations, and perceptual disturbances, and by the severe disruption of ordinary behaviour. Acute onset is defined as a crescendo development of a clearly abnormal clinical picture in about two weeks or less. For these disorders there is no evidence of organic causation. Perplexity and puzzlement are often present but disorientation for time, place and person is not persistent or severe enough to justify a diagnosis of organically caused delirium (F05.-). Complete recovery usually occurs within a few months, often within a few weeks or even days. If the disorder persists, a change in classification will be necessary. The disorder may or may not be associated with acute stress, defined as usually stressful events preceding the onset by one to two weeks.
F23.0 Acute polymorphic psychotic disorder without symptoms of schizophrenia
An acute psychotic disorder in which hallucinations, delusions or perceptual disturbances are obvious but markedly variable, changing from day to day or even from hour to hour. Emotional turmoil with intense transient feelings of happiness or ecstasy, or anxiety and irritability, is also frequently present. The polymorphism and instability are characteristic for the overall clinical picture and the psychotic features do not justify a diagnosis of schizophrenia (F20.-). These disorders often have an abrupt onset, developing rapidly within a few days, and they frequently show a rapid resolution of symptoms with no recurrence. If the symptoms persist the diagnosis should be changed to persistent delusional disorder (F22.-).
Bouffee delirante without symptoms of schizophrenia or unspecified
Cycloid psychosis without symptoms of schizophrenia or unspecified
F23.1 Acute polymorphic psychotic disorder with symptoms of schizophrenia
An acute psychotic disorder in which the polymorphic and unstable clinical picture is present, as described in F23.0; despite this instability, however, some symptoms typical of schizophrenia are also in evidence for the majority of the time. If the schizophrenic symptoms persist the diagnosis should be changed to schizophrenia (F20.-).
Bouffee delirante with symptoms of schizophrenia
Cycloid psychosis with symptoms of schizophrenia
F23.2 Acute schizophrenia-like psychotic disorder
An acute psychotic disorder in which the psychotic symptoms are comparatively stable and justify a diagnosis of schizophrenia, but have lasted for less than about one month; the polymorphic unstable features, as described in F23.0, are absent. If the schizophrenic symptoms persist the diagnosis should be changed to schizophrenia (F20.-).
Acute (undifferentiated) schizophrenia
Brief schizophreniform:
  • disorder
  • psychosis
    Oneirophrenia
    Schizophrenic reaction
      Excludes:
    • organic delusional [schizophrenia-like] disorder ( F06.2 )
    • schizophreniform disorders NOS ( F20.8 )
  • F23.3 Other acute predominantly delusional psychotic disorders
    Acute psychotic disorders in which comparatively stable delusions or hallucinations are the main clinical features, but do not justify a diagnosis of schizophrenia (F20.-). If the delusions persist the diagnosis should be changed to persistent delusional disorder (F22.-).
    Paranoid reaction
    Psychogenic paranoid psychosis
    F23.8 Other acute and transient psychotic disorders
    Any other specified acute psychotic disorders for which there is no evidence of organic causation and which do not justify classification to F23.0-F23.3.
    F23.9 Acute and transient psychotic disorder, unspecified
    Brief reactive psychosis NOS
    Reactive psychosis


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