Skip to main content Accessibility help
×
Home
Hostname: page-component-768ffcd9cc-5rkl9 Total loading time: 0.232 Render date: 2022-11-30T14:08:35.996Z Has data issue: true Feature Flags: { "shouldUseShareProductTool": true, "shouldUseHypothesis": true, "isUnsiloEnabled": true, "useRatesEcommerce": false, "displayNetworkTab": true, "displayNetworkMapGraph": false, "useSa": true } hasContentIssue true

Impact of psychotic features on morbidity and course of illness in patients with bipolar disorder

Published online by Cambridge University Press:  16 April 2020

İ. Özyıldırım*
Affiliation:
Department of Psychiatry, Ünye State Hospital, 52300Ordu, Turkey
S. Çakır
Affiliation:
Mood Disorders Unit, Department of Psychiatry, İstanbul Faculty of Medicine, İstanbul University, 34093İstanbul, Turkey
O. Yazıcı
Affiliation:
Mood Disorders Unit, Department of Psychiatry, İstanbul Faculty of Medicine, İstanbul University, 34093İstanbul, Turkey
*
*Corresponding author. Tel.: +090 536 2853833; fax: +090 452 3233336. E-mail address: ilkerozy@yahoo.com (İ. Özyıldırım).
Get access

Abstract

Objective

In this study, we aimed to compare the clinical features and response patterns to the long-term prophylaxis of bipolar patients with or without psychotic features.

Method

The life charts of patients with bipolar I disorder were evaluated. Two hundred and eighty-one patients who suffer with bipolar disorder for at least 4 years and who had at least three mood episodes were included to the study. The patients whose all episodes are psychotic (psychotic group) and the patients who never experienced psychotic episode (non-psychotic group) were assigned as comparison groups. The clinical features and the response to long-term prophylaxis were compared across the groups.

Results

The psychotic group consists of 43 patients; non-psychotic group consists of 54 patients. The history of bipolar disorder among the first-degree relatives was remarkably more prevalent in non-psychotic group (p = 0.032). The predominance of manic/hypomanic episodes was significantly higher in psychotic group than non-psychotic group; and the rate of depressive episodes were higher in non-psychotic group than psychotic group (p = 0.013). Episodes were more severe (p < 0.001) and hospitalization rates were higher (p = 0.023) in psychotic group. The response to lithium monotherapy was better in non-psychotic group (p < 0.001).

Conclusion

The well identified psychotic subtype of bipolar patients may give important predictions about long term course and prophylaxis of bipolar disorder.

Type
Original articles
Copyright
Copyright © Elsevier Masson SAS 2010

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

American Psychiatric Association. DSM-IV - Diagnostic and Statistical Manual of Mental Disorders, 4th ed. Washington DC: American Psychiatric Association 1994.Google Scholar
Bellivier, F., Golmard, J.L., Henry, C., Leboyer, M., Schurhoff, F.Admixture analysis of age at onset in bipolar I affective disorder. Arch Gen Psychiatry 2001;58:510512.CrossRefGoogle ScholarPubMed
Caetano, S.C., Olvera, R.L., Hunter, K., Hatch, J.P., Najt, P., Bowden, C.et al. Association of psychosis with suicidality in pediatric bipolar I, II and bipolar NOS patients. J Affect Disord 2006;91:3337.CrossRefGoogle ScholarPubMed
Carlson, G.A., Bromet, E.J., Sievers, S.Phenomenology and outcome of subjects with early- and adult-onset psychotic mania. Am J Psychiatry 2000;157:213219.CrossRefGoogle ScholarPubMed
Coryell, W., Leon, A.C., Turvey, C., Akiskal, H.S., Mueller, T., Endicott, J.The significance of psychotic features in manic episodes: A report from the NIMH collaborative study. J Affect Disord 2001;67:7988.CrossRefGoogle ScholarPubMed
Denicoff, K.D., Leverich, G.S., Nolen, W.A., Rush, A.J., McElroy, S.L., Keck, P.E.et al. Validation of the prospective NIMH-Life-Chart Method (NIMH-LCM-p) for longitudinal assessment of bipolar illness. Psychol Med 2000;30:13911397.CrossRefGoogle ScholarPubMed
Garnham, J., Munro, A., Slaney, C., Macdougall, M., Passmore, M., Duffy, A.et al. Prophylactic treatment response in bipolar disorder: results of a naturalistic observation study. J Affect Disord 2007;104:185190.CrossRefGoogle ScholarPubMed
Goldberg, J.F., Harrow, M., Grossman, L.S.Course and outcome in bipolar affective disorder: a longitudinal follow-up study. Am J Psychiatry 1995;152:379384.Google ScholarPubMed
Goldstein, T.R., Birmaher, B., Axelson, D., Ryan, N.D., Strober, M.A., Gill, M.K.et al. History of suicide attempts in pediatric bipolar disorder: factors associated with increased risk. Bipolar Disord 2005;7:525535.CrossRefGoogle ScholarPubMed
Goodwin, F., Jamison, K.Manic-Depressive Illness. New York: Oxford University Press; 1990.Google Scholar
Grunebaum, M.F., Oquendo, M.A., Harkavy-Friedman, J.M., Ellis, S.P., Li, S., Haas, G.L.Delusions and suicidality. Am J Psychiatry 2001;158:743747.CrossRefGoogle ScholarPubMed
Kafantaris, V., Coletti, D.J., Dicker, R., Padula, G., Pollack, S.Are childhood psychiatric histories of bipolar adolescents associated with family history, psychosis, and response to lithium treatment?. J Affect Disord 1998;51:153164.CrossRefGoogle ScholarPubMed
Keck, P.E. Jr., McElroy, S.L., Havens, J.R., Altshuler, L.L., Nolen, W.A., Frye, M.A.et al. Psychosis in bipolar disorder: phenomenology and impact on morbidity and course of illness. Compr Psychiatry 2003;44:263269.CrossRefGoogle ScholarPubMed
Kleindienst, N., Engel, R.R., Greil, W.Which clinical factors predict response to prophylactic lithium? A systematic review for Bipolar disorders. Bipolar Disord 2005;7:404417.CrossRefGoogle ScholarPubMed
Maj, M., Pirozzi, R., Magliano, L.Late non-response to lithium prophylaxis in bipolar patients: prevalence and predictors. J Affect Disord 1996;39:3942.CrossRefGoogle ScholarPubMed
O’Connell, R.A., Mayo, J.A., Flatow, L., Cuthbertson, B., O’Brien, B.Outcome of bipolar disorder on long-term treatment with lithium. Br J Psychiatry 1991;159:123129.CrossRefGoogle ScholarPubMed
Pavuluri, M.N., Herbener, E.S., Sweeney, J.A.Psychotic symptoms in pediatric bipolar disorder. J Affect Disord 2004;80:1928.CrossRefGoogle ScholarPubMed
Pope, H.G. Jr., Lipinski, J.F. Jr.Diagnosis in schizophrenia and manic-depressive illness. A reassessment of the specificity of “schizophrenic” symptoms in the light of current research. Arch Gen Psychiatry 1978;35:811828.CrossRefGoogle ScholarPubMed
Potash, J.B., Chiu, Y.F., MacKinnon, D.F., Miller, E.B., Simpson, S.G., McMahon, F.J.et al. Familial aggregation of psychotic symptoms in a replication set of 69 bipolar disorder pedigrees. Am J Med Genet B Neuropsychiatr Genetics 116B 2003 9097.CrossRefGoogle Scholar
Rende, R., Hodgins, S., Palmour, R., Faucher, B., Allaire, J.F.Familial overlap between bipolar disorder and psychotic symptoms in a Canadian cohort. Can J Psychiatry 2005;50:189194.CrossRefGoogle Scholar
Rende, R., Birmaher, B., Axelson, D., Strober, M., Gill, M.K., Valeri, S.et al. Psychotic symptoms in pediatric bipolar disorder and family history of psychiatric illness. J Affect Disord 2006;96:127131.CrossRefGoogle ScholarPubMed
Rosenthal, N.E., Rosenthal, L.N., Stallone, F., Fleiss, J., Dunner, D.L., Fieve, R.R.Psychosis as a predictor of response to lithium maintenance treatment in bipolar affective disorder. J Affect Disord 1979;1:237245.CrossRefGoogle ScholarPubMed
Sanchez, L., Hagino, O., Weller, E., Weller, R.Bipolarity in children. Psychiatr Clin North Am 1999;22:629648.CrossRefGoogle ScholarPubMed
Tillman, R., Geller, B., Klages, T., Corrigan, M., Bolhofner, K., Zimerman, B.Psychotic phenomena in 257 young children and adolescents with bipolar I disorder: delusions and hallucinations (benign and pathological). Bipolar Disord 2008;10:4555.CrossRefGoogle Scholar
Tohen, M., Waternaux, C.M., Tsuang, M.T.Outcome in mania. A 4-year prospective follow-up of 75 patients utilizing survival analysis. Arch Gen Psychiatry 1990;47:11061111.CrossRefGoogle Scholar
Valles, V., Van Os, J., Guillamat, R., Gutierrez, B., CampilloM, , Gento, P.et al. Increased morbid risk for schizophrenia in families of in-patients with bipolar illness. Schizophr Res 2000;42:8390.CrossRefGoogle ScholarPubMed
Yazıcı, O., Kantemir, E.Prediction of Response to Lithium Prophylaxis. NöroPsikiyatri Arşivi 1992;29:128134.Google Scholar
Yazici, O., Kora, K., Uçok, A., Tunali, D., Turan, N.Predictors of lithium prophylaxis in bipolar patients. J Affect Disord 1999;55:133142.CrossRefGoogle ScholarPubMed
Submit a response

Comments

No Comments have been published for this article.
25
Cited by

Save article to Kindle

To save this article to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Impact of psychotic features on morbidity and course of illness in patients with bipolar disorder
Available formats
×

Save article to Dropbox

To save this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you used this feature, you will be asked to authorise Cambridge Core to connect with your Dropbox account. Find out more about saving content to Dropbox.

Impact of psychotic features on morbidity and course of illness in patients with bipolar disorder
Available formats
×

Save article to Google Drive

To save this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you used this feature, you will be asked to authorise Cambridge Core to connect with your Google Drive account. Find out more about saving content to Google Drive.

Impact of psychotic features on morbidity and course of illness in patients with bipolar disorder
Available formats
×
×

Reply to: Submit a response

Please enter your response.

Your details

Please enter a valid email address.

Conflicting interests

Do you have any conflicting interests? *