Psychosis in bipolar disorder: phenomenology and impact on morbidity and course of illness☆
Section snippets
Method
Patients were evaluated as part of the SFBN naturalistic follow-up study protocol.22 Patients with any type of bipolar disorder were recruited from private, academic, and community mental health clinic outpatient settings by referral and advertisement. Patients were enrolled in the SFBN if they met the following inclusion criteria: (1) age 18 years or older; (2) DSM-IV diagnosis of bipolar I disorder, bipolar II disorder, bipolar disorder not otherwise specified, or schizoaffective disorder,
Results
Three hundred fifty-two patients with bipolar I disorder completed the SCID-P and the patient and clinician questionnaires. All patients were outpatients recruited from the community. Of these 352 patients, 238 (68%) reported a history of psychosis on the patient and clinician questionnaires during at least one mood episode. The prevalence of psychotic symptoms is displayed in Table 1. Mood-congruent (grandiose, referential, and persecutory) delusions were the most prevalent presentations of
Discussion
The prevalence rates and phenomenology of psychotic symptoms in 352 patients with bipolar I disorder, diagnosed according to modern criteria (DSM-IV) using a structured diagnostic interview, were similar to those reported in earlier studies (summarized in by Pope and Lipinski2 and Goodwin and Jamison3). These findings are not surprising and confirm the well-established lack of diagnostic specificity of all types of psychotic symptoms.2, 26
In an analysis of demographic, psychosocial, vocational,
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2022, Schizophrenia ResearchCitation Excerpt :Grandiose delusions are prominent in psychotic mania (approximately 60%), and with delusions of reference equally common. Delusions of persecution are less common (circa 40–50%), with delusions of somatic dysfunction, erotomania and jealousy being relatively uncommon (Burton et al., 2017; Keck et al., 2003b; Picardi et al., 2018). Interestingly, Schneiderian first rank delusions occur in all forms of psychotic bipolar disorders but their prognostic significance remains uncertain (Burton et al., 2017; Carlson et al., 2012; Keck et al., 2003a).
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Supported by the Stanley Medical Research Institute.