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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 ,
S. Çakır  and
O. Yazıcı
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).
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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.

Keywords

Bipolar disordersPsychotic featuresMaintenance treatment
Type
Original articles
Information
European Psychiatry , Volume 25 , Issue 1 , January 2010 , pp. 47 - 51
Copyright
Copyright © Elsevier Masson SAS 2010

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