Bouffée Délirante

Bouffée délirante is an historic and unique French diagnostic term for a short-lived psychosis. The key diagnostic features are acute, floridly psychotic symptoms with complete remission.

It probably can be seen as a culture-bound syndrome as the term has a long history in France, various French-speaking islands in the Caribbean, and erstwhile French colonies in Africa. Some suggest that religious rituals and expectations of the family play a major role in the genesis and maintenance of this sort of delusions[1].

The meaning of the term 'Bouffée délirante' is somewhat obscure. Bouffée is from the verb bouffer, which originally meant 'a puff of air' and is the source of 'buffoon'. But it also had the meaning of 'flash' in the sense of 'short-lived'. Délirante is akin to delirium or psychosis. So, the term can be translated as a 'short-lived psychosis'.

Bouffée délirante is an acute, brief nonorganic psychosis that typically presents with a sudden onset of fully formed, thematically variable delusions and hallucinations against a background of some degree of clouding of consciousness, unstable and fluctuating affect, and spontaneous recovery with some probability of relapse.

The suggested criteria for a diagnosis of Bouffée délirante are: abrupt onset, polymorphic delusions, emotional changes, mood swings, depersonalization, derealization and/or hallucinations, complete remission within weeks or a few months, exclusion of organic causation, alcohol or drug use, and no psychiatric antecedents with the exception of a previous episode of bouffée délirante[2].

As no other country recognises bouffée délirante, international scientists have tried to fit the syndrome into the Diagnostic and Statistical Manual of Mental Disorders 5th edition (DSM-5). The diagnostic category brief psychotic disorder is probably the closest analog of bouffée délirante[3].

However, in some societies similar psychiatric illnesses exist. In certain German speaking countries one can get the diagnosis of cycloid psychosis, while in Scandinavian countries a diagnosis of psychogenic psychosis can be given.

[1] Bhavsar, Bhugra: Religious delusions: finding meanings in psychosis in Psychopathology – 2008
[2] Johnson-Sabine et al: Bouffée délirante: an examination of its current status in Psychological Medicine – 1983
[3] Chabrol: Chronic hallucinatory psychosis, bouffée délirante, and the classification of psychosis in French psychiatry in Current Psychiatry Reports - 2003

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