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Aim: This is the first study on the duration of untreated psychosis and pathways to care among patients with first-episode psychosis in Iran as a developing country., Methods: Ninety-one patients with a first episode of non-organic psychosis admitted to a university-affiliated psychiatric hospital in Iran were assessed for duration of untreated psychosis (DUP), pathways to care and mode of onset., Results: Median DUP was 11 weeks (mean = 52.3 weeks). Following the onset of psychosis, most patients were first seen by a psychiatrist (n = 23, 25.3%), a traditional healer (n = 21, 23.1%) or a general practitioner (n = 16, 17.6%). Most referrals to the psychiatric hospital were made by the family (n = 30, 33.1%), or health professionals (n = 29, 31.9%). Acute onset and rural place of residence were associated with shorter DUP in multivariate analysis., Conclusions: Median DUP was not long in an inpatient sample with first-episode psychosis, which may be due to the preponderance of affective and acute psychoses in this sample and some help-seeking or service variables., (© 2009 The Authors. Journal compilation © 2009 Blackwell Publishing Asia Pty Ltd.)

Objective: The aim of this paper was to investigate the acute treatment response and its predictors in a sample of patients with first-episode psychosis admitted to a psychiatric hospital in Iran., Method: A total of 163 patients with first-episode psychosis were treated with antipsychotics and other medications as prescribed by their treating psychiatrists. Sociodemographic and premorbid data at baseline and clinical data at both baseline and discharge (6+/-1 weeks after admission) were collected., Results: Patients showed a response rate of 71.4% for negative symptoms, 91.5% for positive symptoms and 67.5% for functioning. Those having a positive family history and less severe negative symptoms at baseline were less likely to respond in terms of negative symptoms. Higher premorbid and lower baseline functioning as well as acute onset were associated with the treatment response., Conclusions: Acute treatment response of first-episode psychosis in a clinical sample of a developing country seems to be higher than that of developed countries. However, predictors of response are comparable.

Objective: To examine the short-term stability of Diagnostic and Statistical Manual of Mental Disorders (4th edn; DSM-IV) and International Classification of Diseases (10th revision; ICD-10) diagnoses in a group of patients with first-episode psychosis., Method: Sixty patients with first-episode psychosis admitted consecutively to Roozbeh Hospital, Tehran, were sampled; their illnesses could not be attributed to any medical or substance-induced conditions. Patients were assessed at the time of discharge from the hospital, and at 3, 6 and 12 month intervals following admission. At each visit, two psychiatrists made consensus DSM-IV and ICD-10 diagnoses, based on all available information. Stability was discerned as the consistency between diagnoses at the time of discharge and at 12 month follow up., Results: Forty-eight patients completed follow up. Affective psychotic disorders and schizophrenia in both classification systems were highly stable. In addition, all patients with DSM-IV brief psychotic disorder and ICD-10 acute and transient psychotic disorders remained the same at follow up., Conclusions: Affective psychoses and schizophrenia, in line with previous findings, remained stable. Diagnoses of brief psychoses were highly stable as well; this could reflect a non-relapsing course of acute brief psychoses, especially in developing countries.

Background: There is increasing attention toward the recognition of psychotic disorders with autoimmune etiologies, especially among first-episode psychosis patients. These patients may be underdiagnosed before they develop a full range of neurological symptoms. Objectives: We aimed to characterize the rate and clinical presentations of first-episode autoimmune psychosis patients. Methods: All patients with first-episode psychosis (FEP) with the onset of symptoms over a maximum course of three months were recruited and underwent a comprehensive examination and serum and cerebrospinal fluid autoimmune tests. Results: Seven out of 15 patients with FEP were under 20 years, and four were Afghans. Twelve patients developed prodromal symptoms, all had at least one type of delusion, and 11 patients had experience of hallucinations. Formal thought disorders were detected in seven patients. Five patients had catatonic symptoms. Conclusions: Certain sample features made our cases unique, including young age, high rate of prodromal symptoms, catatonic features, and formal thought disorders. Lack of specific criteria to arrive at the diagnosis of autoimmunepsychosis would be a major milestone to achieve in future studies. [ABSTRACT FROM AUTHOR]