Characteristics of mood-congruent and mood-incongruent psychotic features in bipolar disorder

Abstract

Introduction: Psychotic features in patients with bipolar disorder (BD) have been poorly researched in the con-text of their relationship with the longitudinal course and demographic and clinical characteristics of the illness. Material and methods: In a cross-sectional study of BD patients, comprehensive demographic and clinical characteristics were assessed using the Structured Clinical Instrument for DSM-IV-TR (SCID). Manic symptoms were assessed using Young’s Mania Rating Scale (YMRS), depressive symptoms by the Montgomery-Åsberg Depression Rating Scale (MADRS) and psychotic symptoms with the Scale for Assessment of Positive Symptoms (SAPS). The relationships between these characteristics and psychotic symptoms were analysed. The independent samples t -test was used to assess continuous variables, while the χ 2 test was used to assess categorical data. Results: Psychotic features were associated with BD in 48.94% of patients ( n = 92 out of a total of 188 patients having BD). Of these, 45.74% ( n = 86) had mood-congruent psychotic features and 3.19% ( n = 6) had mood-incongruent psychotic features. All six patients who had mood-incongruent psychotic features had manic symptoms. Conclusions: Our findings suggest that mood-congruent psychotic symptoms in BD are associated with a more severe, predominantly manic illness course. Mean age at onset was 27.76 (±8.54) years for patients with mood-congruent psychotic features and 28.00 (±11.08) years for patients with mood-incongruent psychotic features.