Acute delirious puff

The acute delirious puffed out (or BDA) is a psychiatric affection of the family of the Psychose S. the term of state short psychotic resulting from the terminology DSM-4 is its modern counterpart.

It is about a single episode acute psychotic occurring brutally at a subject without psychiatric antecedents or neurological, in the young people of less than 30 years in general. One distinguishes the states short psychotics occurring without apparent causes and those occurring in contexts from psychosocial or environmental Stress marked. The intensity of the Symptom S, like their more or less brutal appearance and the absence of medical antecedents classically makes evoke in the medical literature the image " of a clap of thunder in a sky serein".

Occurred of such an episode an emergency hospitalization in a service of psychiatry requires. This one is essential in order to start quickly of the care and in a preoccupation with a protection of the patient who is then very vulnerable. The cure starts when the patient gradually takes again conscience of the pathological nature of his state. After this episode of which the duration is generally short if an adapted treatment and a follow-up were set up, the patient can never not relapse or present a new episode in similar circumstances. When the diagnosis of episode short psychotic is confirmed and with the difference in chronic pathologies like the Schizophrénie, these recurrences exist in half of the cases.

The term of BDA is often employed wrongly to define a delirious acute phase at a schizophrenic or bipolar patient, at the time of catches of poisons or associated pathologies. Actually, the forecast of a BDA is distributed between a remission total, without after-effect, and durable, or an evolution towards a bipolar disease or a schizophrenia. The relative share between the various evolutionary forms remains difficult to evaluate precisely. Classically, it is considered that a third is states short psychotics, a third evolve to a schizophrenia, a third towards a bipolar disease. In these the last two cases, a posteriori, one considers that the diagnosis of BDA corresponded in a first state acute psychotic within the framework of a chronic pathology. Therefore the terminology of episode short psychotic was introduced. Indeed, this one clearly separates the episodes specific acute psychotics and those included in a pathology chronic, contrary to the concept of BDA, older.

The question of the diagnostic criteria making it possible at the time of a first episode acute psychotic to direct the diagnosis between a state short psychotic and a state psychotic acute associated with a chronic pathology remains discussed enough. At present, there does not exist definitive answer and scientifically supported with this one. There are all the same certain criteria which one often finds:

For the favorable diagnosis: - brutal beginning of be delirious - a precise factor starting

And for the diagnostic unfavourable one: - is delirious poor - progressive beginning - not of precise factor starting

Lastly, it is important to specify that the medicamentous treatment in the event of episode psychotic in short single must be sufficient, in term of amounts and duration, to avoid an early relapse. The regulation is not so simple because if the episode is single one can have an evolution towards a depression because of the drugs.

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