Despite the frequent occurrence of psychotic symptoms in BD, a recent review revealed that the specific clinical impact of these symptoms is still largely unknown and that the topic has been somewhat neglected in research during more recent years (Smith et al. 2017) than the depressive episodes of the disorder (Goodwin and Jamison 1990 Canuso et al. Psychotic symptoms were reported to be more frequent during the manic (Smith et al. A history of psychotic features in BD was found to be made up by 92.5% of delusions and 58% of hallucinations (Bergen et al. The more severe course of patients with psychotic features, and particularly those with MI psychotic features, highlights the need for thorough psychopathological evaluations to assess the presence of these symptoms to install appropriate treatment.Ĭlinical studies have estimated the prevalence of psychotic features to be as high as 50–75% in patients with bipolar disorder (BD) (Goodwin and Jamison 1990 Coryell et al. Our data provide additional support for both the distinction between BD-I with and without psychotic features as well as the distinction between MI and MC psychotic features. Within patients with psychotic symptoms, those with MI features showed more clinical severity in terms of a higher likelihood of reporting hallucinations, suicidal attempts and comorbid cannabis dependence. (2) Patients with psychotic features were much less likely to be professionally active, revealed alcohol abuse more frequently and used health care, particularly inpatient treatment, more frequently than those without psychotic features. Among them, 44.8% revealed MI features at least once in their lives. (1) A total of 96 patients (59.3%) had experienced psychotic features over their lifetime. Clinical, course and treatment characteristics relied on information elicited through direct diagnostic interviews, family history reports and medical records. MethodsĪ sample of 162 treated patients with BD I (60.5% female, mean age = 41.4 (s.d: 10.2) years) was recruited within a large family study of mood disorders. Using a sample of thoroughly assessed patients with BD I our aims were to: (1) establish the proportion of those with MI and MC features, and (2) compare BD I patients with and without psychotic features as well as those with MI to those with MC features on a wide array of socio-demographic and clinical characteristics including course, psychiatric comorbidity and treatment. However, many pre-existing studies have been affected by serious methodological limitations. In contrast, other studies establishing the associations of psychotic features in BD I, and in particular of mood-congruent (MC) and mood-incongruent (MI) features, with clinical characteristics have yielded contradictory results. The occurrence of psychotic features within mood episodes in patients with bipolar I disorder (BD I) has been associated in some studies with a more severe clinical and socio-professional profile.
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