Fever and acute brief psychosis in urban and rural settings in north India

Background: This case-control study used data from Chandigarh, North India to investigate the association between antecedent fever and acute brief psychosis. Aims: To assess whether antecedent fever may be a biological correlate of acute brief psychosis, and contribute to the nosology of acute brief psychosis. Method: The study was based in an incidence cohort from two catchment areas, an urban and a rural site, that were part of the World Health Organization Determinants of Outcome study. The cases (n=17) met criteria for acute brief psychosis; controls (n=40) were patients with other acute and subacute psychoses. The Life Events Schedule was used to determine the presence of antecedent fever. Results: The crude odds ratio for fever as a risk factor for acute brief psychosis was 6.2 (P=0.004). The odds ratio in a logistic regression analysis - adjusted for site, gender and CATEGO classification - was 11.2 (P=0.003). Conclusions: Antecedent fever may be a biological correlate of acute brief psychosis. This finding supports the validity of this entity, and has implications for its aetiology and diagnosis. Declaration of interest: Supported by the National Institute of Mental Health, USA.