I don’t think Bouffée délirante is a culture bound syndrome - it’s just the French equivalent of brief psychotic disorder (DSM), acute and transient psychotic disorder (ICD), or Brief Limited Intermittent Psychotic symptoms (CAARMS).
Have you ever seen BPS? I almost never have, and was told it was mostly used as a code for new-onset schizophrenia that didn't satisfy the time criterion yet.
At 3 years follow-up, 1/3 of brief psychotic disorders will have developed a persistent psychotic disorder (ref in my original comment) but I guess that means that most do not.
I'm not a psychiatrist, but I have seen BPS twice (once in a colleague and once in a close acquaintance). Both matched the description of Bouffée délirante/BPS, got better in about 2 weeks, and were not followed by any relapse of any psychotic symptome. (Also, both happened outside France to non-French people.)
I suspect a possible selection effect - bias on your behalf here.
Think about it: Most of those who experience BPS are unlikely to ever see a psychiatrist. Precisely because it is a one-off experience.
...or if they do, they are probably going to terminate their consultations with a psychiatrist much earlier that the skizophrenic types.
...implying that psychiatrists' view of "what is the usual trajectory" is biased toward the long-term ill, rather than the fast-recovering. The latter might theoretically be the dominant/more common group.
Mind you, this is an hypothesis; I have not checked the numbers. (And checking the numbers will in any case be difficult, or almost impossible, to do, if it turns out that most cases of BPS go unrecorded.)
I'm a french senior psychiatrist. I was told in my intership that "Bouffée délirante aigüe" is a clinical entity, not a syndrom, which appears to have a pretty name coined by a french a alienist from classical era. Although unnamed, the concept exist everywhere.
It's simply that, in most psychotic disorders, it's easy to make a syndromic diagnosis, mostly from the biography or other upstream clinical features. For exemple, megalomaniac delusions + speech acceleration + decrease sleep in someone who has post partum depression antecedent and bipolar disorder in her family : easy, it's a manic episod.
But, in some cases it's not possible to draw a firm conclusion. Mostly when it's a first episode (with affective AND psychotic symptoms), without prior symptoms and with fair psycho-social functioning. Hence the concept of "bouffée délirante aigüe" wich mean "I have no clue yet about what the fuck happen". Traditionaly it is said that the outcome is 1/3 schizophrenia, 1/3 bipolar disorder, 1/3 brief psychotic disorder (borderline personnality disorder, undiagnosed pharmacopsychosis, anti-NMDA encephalitis...).
Same issue everywhere, actually. We, French, have a poetic name for it.
To be fair the initial description from Magnan (1866) is limited to the brief psychotis disorder, while "Le manuel d'Henri Hey" (i only have the 1989 edition, but it was mostly writed between 1950-1980) is quite unclear about what is or not the "Bouffé délirante aigüe".
I don’t think Bouffée délirante is a culture bound syndrome - it’s just the French equivalent of brief psychotic disorder (DSM), acute and transient psychotic disorder (ICD), or Brief Limited Intermittent Psychotic symptoms (CAARMS).
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8581951/
Have you ever seen BPS? I almost never have, and was told it was mostly used as a code for new-onset schizophrenia that didn't satisfy the time criterion yet.
Yes, in the context of an At Risk Mental State service, where it makes up roughly 20% of referrals https://www.sciencedirect.com/science/article/pii/S0924977X20302510
At 3 years follow-up, 1/3 of brief psychotic disorders will have developed a persistent psychotic disorder (ref in my original comment) but I guess that means that most do not.
I'm not a psychiatrist, but I have seen BPS twice (once in a colleague and once in a close acquaintance). Both matched the description of Bouffée délirante/BPS, got better in about 2 weeks, and were not followed by any relapse of any psychotic symptome. (Also, both happened outside France to non-French people.)
I suspect a possible selection effect - bias on your behalf here.
Think about it: Most of those who experience BPS are unlikely to ever see a psychiatrist. Precisely because it is a one-off experience.
...or if they do, they are probably going to terminate their consultations with a psychiatrist much earlier that the skizophrenic types.
...implying that psychiatrists' view of "what is the usual trajectory" is biased toward the long-term ill, rather than the fast-recovering. The latter might theoretically be the dominant/more common group.
Mind you, this is an hypothesis; I have not checked the numbers. (And checking the numbers will in any case be difficult, or almost impossible, to do, if it turns out that most cases of BPS go unrecorded.)
Yes, this is the Clinician’s Illusion https://jamanetwork.com/journals/jamapsychiatry/article-abstract/493477#
Thanks for the reference.
Hi,
I'm a french senior psychiatrist. I was told in my intership that "Bouffée délirante aigüe" is a clinical entity, not a syndrom, which appears to have a pretty name coined by a french a alienist from classical era. Although unnamed, the concept exist everywhere.
It's simply that, in most psychotic disorders, it's easy to make a syndromic diagnosis, mostly from the biography or other upstream clinical features. For exemple, megalomaniac delusions + speech acceleration + decrease sleep in someone who has post partum depression antecedent and bipolar disorder in her family : easy, it's a manic episod.
But, in some cases it's not possible to draw a firm conclusion. Mostly when it's a first episode (with affective AND psychotic symptoms), without prior symptoms and with fair psycho-social functioning. Hence the concept of "bouffée délirante aigüe" wich mean "I have no clue yet about what the fuck happen". Traditionaly it is said that the outcome is 1/3 schizophrenia, 1/3 bipolar disorder, 1/3 brief psychotic disorder (borderline personnality disorder, undiagnosed pharmacopsychosis, anti-NMDA encephalitis...).
Same issue everywhere, actually. We, French, have a poetic name for it.
To be fair the initial description from Magnan (1866) is limited to the brief psychotis disorder, while "Le manuel d'Henri Hey" (i only have the 1989 edition, but it was mostly writed between 1950-1980) is quite unclear about what is or not the "Bouffé délirante aigüe".
Sorry for my english,
TH.
Always interesting to hear the French perspective, thank you for sharing!
You're welcome. I will follow your substack !