Suicidal behavior in acute and transient psychotic disorders.

The aim of the study was to investigate the frequency and characteristics of suicidal behavior in a cohort of patients with acute transient psychotic disorder (ATPD), diagnosed according to ICD-10 (F23). In a longitudinal study, 42 patients fulfilling the ICD-10 criteria of ATPD were investigated in comparison to matched control groups with 'positive schizophrenia' (PS) and bipolar schizoaffective disorder (BSAD). Suicidal behavior was studied in the index episode and during the long-term course, including a 5-year prospective follow-up. The prevalence of suicidal behavior during the entire course of illness in ATPD was 35.7% compared to 57.1% in BSAD and 40.5% in PS. The difference was not significant when the duration of the illness was taken into account. Suicidal behavior in ATPD was associated with the acute episode, while in PS, suicidal behavior mainly occurred during the longitudinal course. In logistic regression models, suicidal behavior was associated with a higher educational level and lower conscientiousness in the NEO Five-Factor Inventory for patients with PS, but not ATPD. Suicidal behavior in ATPD is frequent, in particular during the acute episode. It seems to be associated with the dramatic psychotic symptomatology during the acute episode.