Diagnostic stability and predictive factors of acute and transient psychotic disorders: A naturalistic observational study

Objective:This study aims to evaluate the diagnostic stability as well as the clinical and sociodemographic variables influencing diagnostic changes in patients diagnosed with acute and transient psychotic disorder (ATPD). Method: A retrospective observational study was conducted at Gazi University Faculty of Medicine, Psychiatry Department. Sociodemographic and clinical data were collected, including age, gender, marital status, education, employment status, duration of symptoms, hospitalization history, substance use, and pre-diagnostic stressors. Multivariate logistic regression analysis was employed to identify independent predictors of diagnostic change. Results: A total of 106 patients (57 males, 49 females) with a mean age of 29.90 +/- 10.33 years were included in the study. The diagnostic stability of ATPD was observed in 17.8% of cases. Over a three-year follow-up period, 62.3% of patients were diagnosed with schizophrenia and other psychotic disorders. Significant differences between diagnostic groups were found in terms of education (chi 2=9.776, p=0.008) and hospitalization (chi 2=8.083, p=0.018). Multivariate logistic regression analysis revealed that younger age at onset (odds ratio [OR]=0.951, 95% confidence interval [CI] 0.90-0.96; p=0.032) and lower educational level (OR=0.219, 95% CI 0.08-0.54; p=0.001) were significantly associated with a diagnostic shift to schizophrenia and other psychotic disorders. Conclusion: The diagnostic stability of ATPD in Turkiye was found to be low, with most diagnostic changes shifting towards schizophrenia and related psychotic disorders. Lower educational status and younger age at onset were significant predictors of diagnostic change. These findings underscore the need for large-scale, prospective studies to better understand the factors influencing diagnostic stability and the roles of clinician attitudes and stigma in ATPD diagnosis.