{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T12:15:38Z","timestamp":1793189738509,"version":"4.5.0"},"reference-count":66,"publisher":"Cambridge University Press (CUP)","license":[{"start":{"date-parts":[[2021,11,4]],"date-time":"2021-11-04T00:00:00Z","timestamp":1635984000000},"content-version":"unspecified","delay-in-days":307,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Epidemiol Psychiatr Sci"],"published-print":{"date-parts":[[2021]]},"abstract":"<jats:title>Abstract<\/jats:title>\n\t  <jats:sec id=\"S2045796021000548_sec_a1\">\n\t    <jats:title>Aims<\/jats:title>\n\t    <jats:p>Patients with brief psychotic episodes (BPE) have variable and fluctuating clinical outcomes which challenge psychiatric care. Our meta-analysis aims at providing a comprehensive summary of several clinical outcomes in this patient group.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S2045796021000548_sec_a2\" sec-type=\"methods\">\n\t    <jats:title>Methods<\/jats:title>\n\t    <jats:p>A multistep systematic PRISMA\/MOOSE-compliant literature search was performed for articles published from inception until 1st March 2021. Web of Science database was searched, complemented by manual search of original articles reporting relevant outcomes (psychotic recurrence, prospective diagnostic change or stability, remission, quality of life, functional status, mortality and their predictors) for patients diagnosed with acute and transient psychotic disorders (ATPD), brief psychotic disorders (BPD), brief intermittent psychotic symptoms (BIPS) and brief limited intermittent psychotic symptoms (BLIPS). Random-effects methods and <jats:italic>Q<\/jats:italic>-statistics were employed, quality assessment with Newcastle-Ottawa Scale, assessment of heterogeneity with <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup> index, sensitivity analyses (acute polymorphic psychotic disorders, APPD) and multiple meta-regressions, assessment of publication bias with funnel plot, Egger's test and meta-regression (psychotic recurrence and sample size).<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S2045796021000548_sec_a3\" sec-type=\"results\">\n\t    <jats:title>Results<\/jats:title>\n\t    <jats:p>A total of 91 independent articles (<jats:italic>n<\/jats:italic> = 94 samples) encompassed 37 ATPD, 24 BPD, 19 BLIPS and 14 BIPS samples, totalling 15 729 individuals (mean age: 30.89 \u00b1 7.33 years, mean female ratio: 60%, 59% conducted in Europe). Meta-analytical risk of psychotic recurrence for all BPE increased from 15% (95% confidence interval (CI) 12\u201318) at 6 months, 25% (95% CI 22\u201330) at 12 months, 30% (95% CI 27\u201333) at 24 months and 33% (95% CI 30\u201337) at \u2a7e36 months follow-up, with no differences between ATPD, BPD, BLIPS and BIPS after 2 years of follow-up. Across all BPE, meta-analytical proportion of prospective diagnostic stability (average follow-up 47 months) was 49% (95% CI 42\u201356); meta-analytical proportion of diagnostic change (average follow-up 47 months) to schizophrenia spectrum psychoses was 19% (95% CI 16\u201323), affective spectrum psychoses 5% (95% CI 3\u20137), other psychotic disorders 7% (95% CI 5\u20139) and other (non-psychotic) mental disorders 14% (95% CI 11\u201317). Prospective diagnostic change within APPD without symptoms of schizophrenia was 34% (95% CI 24\u201346) at a mean follow-up of 51 months: 18% (95% CI 11\u201330) for schizophrenia spectrum psychoses and 17% (95% CI 10\u201326) for other (non-psychotic) mental disorders. Meta-analytical proportion of baseline employment was 48% (95% CI 38\u201358), whereas there were not enough data to explore the other outcomes. Heterogeneity was high; female ratio and study quality were negatively and positively associated with risk of psychotic recurrence, respectively. There were no consistent factor predicting clinical outcomes.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S2045796021000548_sec_a4\" sec-type=\"conclusions\">\n\t    <jats:title>Conclusions<\/jats:title>\n\t    <jats:p>Short-lived psychotic episodes are associated with a high risk of psychotic recurrences, in particular schizophrenia spectrum disorders. Other clinical outcomes remain relatively underinvestigated. There are no consistent prognostic\/predictive factors.<\/jats:p>\n\t  <\/jats:sec>","DOI":"10.1017\/s2045796021000548","type":"journal-article","created":{"date-parts":[[2021,11,9]],"date-time":"2021-11-09T04:23:52Z","timestamp":1636431832000},"source":"Crossref","is-referenced-by-count":19,"title":["Clinical outcomes in brief psychotic episodes: a systematic review and meta-analysis"],"prefix":"10.1017","volume":"30","author":[{"given":"U.","family":"Provenzani","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G.","family":"Salazar de Pablo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Arribas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F.","family":"Pillmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3582-6788","authenticated-orcid":false,"given":"P.","family":"Fusar-Poli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2021,11,4]]},"reference":[{"key":"S2045796021000548_ref7","doi-asserted-by":"publisher","DOI":"10.1016\/j.schres.2019.07.043"},{"key":"S2045796021000548_ref24","doi-asserted-by":"publisher","DOI":"10.1016\/j.eurpsy.2016.11.010"},{"key":"S2045796021000548_ref23","doi-asserted-by":"publisher","DOI":"10.1093\/schbul\/sbw151"},{"key":"S2045796021000548_ref22","doi-asserted-by":"publisher","DOI":"10.1093\/schbul\/sbw020"},{"key":"S2045796021000548_ref25","doi-asserted-by":"publisher","DOI":"10.1001\/jamapsychiatry.2018.2530"},{"key":"S2045796021000548_ref47","doi-asserted-by":"publisher","DOI":"10.1002\/wps.20524"},{"key":"S2045796021000548_ref28","doi-asserted-by":"publisher","DOI":"10.1002\/wps.20631"},{"key":"S2045796021000548_ref64","volume-title":"The ICD-10 Classification of Mental and Behavioural Disorders: Clinical Descriptions and Diagnostic Guidelines","year":"1992"},{"key":"S2045796021000548_ref27","doi-asserted-by":"publisher","DOI":"10.1017\/S2045796019000635"},{"key":"S2045796021000548_ref26","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2019.00764"},{"key":"S2045796021000548_ref44","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.bp.113.127340"},{"key":"S2045796021000548_ref18","doi-asserted-by":"publisher","DOI":"10.1002\/wps.20681"},{"key":"S2045796021000548_ref50","doi-asserted-by":"publisher","DOI":"10.1186\/1744-859X-13-4"},{"key":"S2045796021000548_ref48","doi-asserted-by":"publisher","DOI":"10.1002\/wps.20611"},{"key":"S2045796021000548_ref66","volume-title":"Comprehensive Assessment of At-Risk Mental State","author":"Yung AR","year":"2006"},{"key":"S2045796021000548_ref46","doi-asserted-by":"publisher","DOI":"10.1080\/08039480701352454"},{"key":"S2045796021000548_ref41","doi-asserted-by":"publisher","DOI":"10.1177\/0957154X030142002"},{"key":"S2045796021000548_ref33","doi-asserted-by":"publisher","DOI":"10.1111\/j.1447-0594.2009.00505.x"},{"key":"S2045796021000548_ref60","first-page":"252","article-title":"Development and validation of a dynamic risk prediction model to forecast psychosis onset in patients at clinical high risk","volume":"46","author":"Studerus","year":"2020","journal-title":"Schizophrenia Bulletin"},{"key":"S2045796021000548_ref61","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440-1819.2005.01349.x"},{"key":"S2045796021000548_ref52","doi-asserted-by":"publisher","DOI":"10.1034\/j.1600-0447.2002.01080.x"},{"key":"S2045796021000548_ref20","doi-asserted-by":"publisher","DOI":"10.1001\/jamapsychiatry.2015.2313"},{"key":"S2045796021000548_ref8","doi-asserted-by":"publisher","DOI":"10.1159\/000357784"},{"key":"S2045796021000548_ref36","doi-asserted-by":"publisher","DOI":"10.1007\/s00406-019-01014-z"},{"key":"S2045796021000548_ref40","unstructured":"National Institute for Health and Care Excellence (2014) Psychosis and schizophrenia in adults: prevention and management. NICE guidelines [CG178]."},{"key":"S2045796021000548_ref56","doi-asserted-by":"publisher","DOI":"10.1111\/eip.12515"},{"key":"S2045796021000548_ref62","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2019.00053"},{"key":"S2045796021000548_ref32","doi-asserted-by":"publisher","DOI":"10.1093\/schbul\/sbs104"},{"key":"S2045796021000548_ref17","first-page":"201","article-title":"Bouff\u00e9es d\u00e9lirantes et psychoses hallucinatoires aigu\u00ebs","volume":"23","author":"Ey","year":"1954","journal-title":"\u00c9tudes Psychiatriques T III, \u00e9tude"},{"key":"S2045796021000548_ref14","volume-title":"Standards for Early Intervention in Psychosis Services","author":"Chandra","year":"2018"},{"key":"S2045796021000548_ref9","doi-asserted-by":"publisher","DOI":"10.1016\/j.comppsych.2007.10.004"},{"key":"S2045796021000548_ref43","doi-asserted-by":"publisher","DOI":"10.1080\/08039488.2016.1252426"},{"key":"S2045796021000548_ref30","doi-asserted-by":"publisher","DOI":"10.1002\/wps.20896"},{"key":"S2045796021000548_ref37","volume-title":"The Psychosis-Risk Syndrome: Handbook for Diagnosis and Follow-up","author":"McGlashan","year":"2010"},{"key":"S2045796021000548_ref53","doi-asserted-by":"publisher","DOI":"10.1038\/s41398-020-01165-x"},{"key":"S2045796021000548_ref55","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph17010260"},{"key":"S2045796021000548_ref21","doi-asserted-by":"publisher","DOI":"10.1001\/jamapsychiatry.2015.2324"},{"key":"S2045796021000548_ref39","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1000097"},{"key":"S2045796021000548_ref45","doi-asserted-by":"publisher","DOI":"10.1002\/wps.20490"},{"key":"S2045796021000548_ref4","volume-title":"Diagnostic and Statistical Manual of Mental Disorders: DSM-5","year":"2013"},{"key":"S2045796021000548_ref11","doi-asserted-by":"publisher","DOI":"10.1177\/0004867412461692"},{"key":"S2045796021000548_ref13","doi-asserted-by":"publisher","DOI":"10.1111\/jcpp.13322"},{"key":"S2045796021000548_ref59","doi-asserted-by":"publisher","DOI":"10.1001\/jama.283.15.2008"},{"key":"S2045796021000548_ref6","volume-title":"Comprehensive Meta-Analysis Version 3","author":"Borenstein","year":"2013"},{"key":"S2045796021000548_ref57","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.185.6.452"},{"key":"S2045796021000548_ref51","doi-asserted-by":"publisher","DOI":"10.1016\/j.eurpsy.2018.05.004"},{"key":"S2045796021000548_ref29","doi-asserted-by":"publisher","DOI":"10.1016\/j.eclinm.2020.100578"},{"key":"S2045796021000548_ref34","volume-title":"Psychiatrie - ein Lehrbuch f\u00fcr Studierende und \u00c4rzte","author":"Kraepelin","year":"1899"},{"key":"S2045796021000548_ref31","article-title":"Diagnosis, prognosis and treatment of brief psychotic episodes: a review and research agenda","author":"Fusar-Poli","year":"2021b","journal-title":"The Lancet. Psychiatry"},{"key":"S2045796021000548_ref1","doi-asserted-by":"publisher","DOI":"10.3109\/08039488.2011.565800"},{"key":"S2045796021000548_ref49","doi-asserted-by":"publisher","DOI":"10.3109\/08039488.2012.761726"},{"key":"S2045796021000548_ref10","doi-asserted-by":"publisher","DOI":"10.1111\/acps.12077"},{"key":"S2045796021000548_ref15","doi-asserted-by":"publisher","DOI":"10.1093\/schbul\/sbab070"},{"key":"S2045796021000548_ref63","doi-asserted-by":"publisher","DOI":"10.1016\/j.schres.2017.07.011"},{"key":"S2045796021000548_ref65","doi-asserted-by":"publisher","DOI":"10.1093\/schbul\/22.2.283"},{"key":"S2045796021000548_ref54","doi-asserted-by":"publisher","DOI":"10.4088\/JCP.09m05311yel"},{"key":"S2045796021000548_ref3","doi-asserted-by":"publisher","DOI":"10.1007\/s40263-016-0331-x"},{"key":"S2045796021000548_ref12","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-7610.2011.02443.x"},{"key":"S2045796021000548_ref19","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2021.698406"},{"key":"S2045796021000548_ref5","doi-asserted-by":"publisher","DOI":"10.1016\/j.schres.2013.07.011"},{"key":"S2045796021000548_ref38","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.schbul.a007040"},{"key":"S2045796021000548_ref58","doi-asserted-by":"publisher","DOI":"10.1038\/s41380-021-01161-7"},{"key":"S2045796021000548_ref35","volume-title":"Practical Meta-Analysis","author":"Lipsey","year":"2001"},{"key":"S2045796021000548_ref2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440-1819.2006.01531.x"},{"key":"S2045796021000548_ref42","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.187.3.286"},{"key":"S2045796021000548_ref16","doi-asserted-by":"publisher","DOI":"10.1177\/0020764013495525"}],"container-title":["Epidemiology and Psychiatric Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S2045796021000548","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,11,9]],"date-time":"2021-11-09T04:24:02Z","timestamp":1636431842000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S2045796021000548\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021]]},"references-count":66,"alternative-id":["S2045796021000548"],"URL":"https:\/\/doi.org\/10.1017\/s2045796021000548","relation":{},"ISSN":["2045-7960","2045-7979"],"issn-type":[{"value":"2045-7960","type":"print"},{"value":"2045-7979","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021]]},"article-number":"e71"}}