Gangguan Psikotik Akut (Acute

&transient psychotic disorder)

Debby Rosyida
201210330311025
Definition
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. (ICD 10)
Sign and symptom (Key features of ATPD
according to ICD 10 (WHO 1992)
1. Onset
acute onset (within 2 weeks)
or abrupt onset (within 48 hours)
2. Presence of typical syndromes
polymorphic (rapidly changing, variable state)
typical schizophrenic symptoms
3. Presence of associated acute stress
(Bereavement, unexpected loss of partner or
job, marriage, psychological trauma of combat,
terrorism, torture)
Subtypes of ATPD (WHO 1992)
F 23.0 Acute polymorphic psychotic disorder without
symptoms of schizophrenia
F 23.1 Acute polymorphic psychotic disorder with symptoms
of schizophrenia
F 23.2 Acute schizophrenia-like psychotic disorder
F 23.3 Other acute predominantly delusional psychotic
disorders
F 23.8 Other acute and transient psychotic disorders
F 23.9 Acute and transient psychotic disorder, unspecified
Acute polymorphic psychotic disorder without symptoms of
schizophrenia

Definition : 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.
Sign & symptom:
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
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.
Acute polymorphic psychotic disorder
with symptoms of schizophrenia
Definition : An acute psychotic disorder in which
the polymorphic and unstable clinical picture is
present, as described in F23.0
Sign & symptom:
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
Acute schizophrenia-like psychotic
disorder
Definition : 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
Sign & symptom:
the polymorphic unstable features, as described in
F23.0, are absent.
If the schizophrenic symptoms persist the
diagnosis should be changed to schizophrenia
Other acute predominantly
delusional psychotic disorders
Definition : Acute psychotic disorders in which
comparatively stable delusions or hallucinations
are the main clinical features, but do not justify a
diagnosis of schizophrenia
Sign & symptom:
comparatively stable delusions or hallucinations
If the delusions persist the diagnosis should be
changed to persistent delusional disorder
Paranoid reaction, Psychogenic paranoid psychosis
Other acute and transient psychotic
disorders
Definition : 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.
Acute and transient psychotic
disorder, unspecified
Brief reactive psychosis NOS
Reactive psychosis
Daftar Pustaka
http://apps.who.int/classifications/icd10/browse/2
015/en#/F23
ICD 10 version 2015
Farooq, Saee, 2012: Is Acute And Transient Psychotic
Disorder (ATPD) Mini Schizophrenia? The Evidence
From Phenomenology And Epidemiology. Psychiatria
Danubina ; Vol. 24, Suppl. 3, pp 311315
Mahajudin, S. Marlina et al, 2004:Pedoman
diagnosis dan terapi bag/smf ilmu kedokteran jiwa
Edisi III. Rumah Sakit Umum Dokter Soetomo
Surabaya, hlm 32-35.
Acute and transient psycotyc
disorder
Eva Aulia Rosidah
201210330311022
diagnose
Key features of acute and transient psychotic disorders
:
suddenness of onset (within 2 weeks or less)

presence of typical syndromes with polymorphic

(changing and variable) or schizophrenic symptoms

presence of associated acute stress (stressful events

such as bereavement, job loss, psychological

trauma, etc.)
 acute onset : change from a state without psychotic

features to a clearly abnormal psychotic state within less

than 2 weeks

abrupt onset within 48 hours

typical syndromes rapidly changing and variable state

polymorphic
associated acute stress within about 2 weeks of an event

regarded as stressful [bereavement, unexpected loss of

partner or job, psychological trauma of combat,
terrorism, torture]
 Treatment of acute psychotic
states
Antipsychotics 1st generation:
Phenothiazines [chlorpromazine 50-100mgs i.m.,

levomepromazine 25-50mgs i.m.]

Butyrophenons [haloperidol 5mgs i.m.,
melperon-Buronil p.o.]
Thioxanthens [zuclopenthixol {Cisordinol
Acutard} 50-150mgs i.m., chlorprothixen]
 Treatment of acute psychotic
states cont.
Antipsychotics 2nd generation:

Selective antagonists of dopamine receptors [D2, D3]:

sulpiride {Dogmatil}, amisulprid {Solian}
SDA [antagonists of serotonine and dopamine receptors]:
risperidon {Risperdal, Rispen}, ziprasidon {Zeldox}
MARTA [multireceptors antagonists]: clozapin {Leponex},
olanzapin {Zyprexa}, quetiapin {Seroquel}, zotepin {Zoleptil}
Aripiprazol {Abilify}
 doc. MUDr. Pavel Pavlovsk, CSc.Department of
Psychiatry, First Faculty of Medicine, Charles
University and General University Hospital in
Prague. 2013
http://www.currentpsychiatry.com/home/articl
e/how-to-stabilize-an-acutely-psychotic-pati
ent/886398ca6574d408a67439288e502f88.html
. Hannah E. Brown, MD. 2012