Clinical correlates of acute bipolar depressive episode with psychosis

Caldieraro, Marco Antônio; Sylvia, Louisa G.; Dufour, Steven; Walsh, Samantha; Janos, Jessica; Rabideau, Dustin J.; Kamali, Masoud; McInnis, Melvin G.; Bobo, William V.; Friedman, Edward S.; Gao, Keming; Tohen, Mauricio; Reilly-Harrington, Noreen A.; Ketter, Terence A.; Calabrese, Joseph R.; McElroy, Susan L.; Thase, Michael E.; Shelton, Richard C.; Bowden, Charles L.; Kocsis, James H.; Deckersbach, Thilo; Nierenberg, Andrew A.

doi:10.1016/j.jad.2017.03.059

Cited by 19 publications

(23 citation statements)

References 33 publications

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“…In BD, depressive and manic episodes are associated with psychotic symptoms in 9-66% and 33-96%, respectively (Fountoulakis 2015). Others also reported that psychotic symptoms are more common in manic than in depressive episodes (Altamura et al 2015, Caldieraro et al 2017, Keck et al 2003. Moreover, the rate of psychotic symptoms in mixed episodes is more frequent than in depression and similar to that of mania (approximately 40%) (Fountoulakis 2015).…”

Section: Introductionmentioning

confidence: 97%

Differences in Clinical Characteristics Between Bipolar Patients With Current Psychotic Symptoms and Those Who Have Never Been Psychotic

Belteczki¹,

Rihmer²,

Ujvari³

et al. 2018

Psychiat Danub

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Section: Introductionmentioning

confidence: 97%

Differences in Clinical Characteristics Between Bipolar Patients With Current Psychotic Symptoms and Those Who Have Never Been Psychotic

Belteczki¹,

Rihmer²,

Ujvari³

et al. 2018

Psychiat Danub

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“…Caetano and colleagues showed that psychotic symptoms in youths with BD were associated with more suicidal ideation and plans and psychiatric hospitalizations . Finally, although not consistently, the adult BD literature has also reported that the presence of psychosis in patients with BD is associated with poor course and outcome …”

Section: Discussionmentioning

confidence: 99%

“…8 Finally, although not consistently, the adult BD literature has also reported that the presence of psychosis in patients with BD is associated with poor course and outcome. 9,10,12,13,[15][16][17][18][19]33,34 BDP+ youths appear to be a distinct subgroup of BD, as evidenced by the fact that they had more severe psychopathology, and had families with lower SES and more psychopathology, even before These findings may represent a common physiological mechanism associated with the vulnerability to psychosis in people with BD, and may suggest that the presence of psychosis in BD represents a unique subtype of the disorder. 14 Also, the experience of being psychotic may have a significant impact on one's self-concept (eg, poor self-esteem, depression, anxiety), 36 and lead to environmental stressors (eg, peer rejection) 37 and PTSD-like symptoms regarding the traumatic psychotic experience, which may last for months after the psychosis has resolved.…”

Section: Schizoaffective Disorder and Schizophreniamentioning

confidence: 99%

“…Most, but not all, of the existing studies of BD adults have shown that the presence of psychosis is generally associated with worse prognosis ( Table 1). Both cross-sectional and longitudinal studies report that adults with BDP+ have more severe psychopathology, including mood symptoms, poorer functioning, [9][10][11][12][13] and more cognitive deficits 14 than BDP− adults. Nevertheless, some of the cross-sectional studies showed no clinical or functional differences between BDP+ and BDP− adults, [15][16][17] and some even show a clinical advantage of BDP+ compared to BDP−.…”

Section: Introductionmentioning

confidence: 99%

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Longitudinal course and risk factors associated with psychosis in bipolar youths

et al. 2019

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Objectives To compare the longitudinal clinical course of youths with bipolar disorder (BD) spectrum with lifetime (past, intake, and/or follow‐up) psychosis (BDP+) to youths with BD without lifetime psychosis (BDP−). Also, to identify risk factors associated with increased risk of first onset of psychosis during prospective follow‐up. Method Bipolar disorder youths (BDP+ = 137, BDP− = 233), aged 7‐17 years old, were followed on average every 7 months for 11.7 years and were evaluated using standardized instruments. Data were analyzed using linear and generalized linear models for the full sample, as well as for youths who developed first period of psychosis (n = 55). Results After adjusting for confounders, BDP+ youths with one, and in particular ≥2 lifetime psychotic episodes, had higher rates and more severe mood and anxiety symptoms, higher rates of suicidality, psychiatric hospitalizations, and sexual/physical abuse, and poorer psychosocial functioning than BDP− youths. Even before the first onset of psychosis during follow‐up, BDP+ youths showed more psychopathology and had more family history of psychiatric illness than those who never developed psychosis. First‐onset psychosis was associated with low socioeconomic status (SES), living with one parent, bipolar disorder type one and type two, comorbid anxiety, history of hospitalizations, and family history of mania and suicidality. Conclusion BDP+ is associated with poor prognosis and worse clinical picture, even before the onset of psychosis, indicating the need for prompt identification and treatment of these youths. Studies aimed to treat acute symptoms of psychosis, as well as prevent the onset of psychosis, including risk factors amenable to change, are warranted.

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“…Psychotic features are more frequent and more recurrent in bipolar depression compared to major depressive disorder (MDD) (Frankland et al, 2015;Goes et al, 2007;Mitchell et al, 2001;Zaninotto et al, 2015), and more than a third of individuals who experience their first psychotic unipolar depressive episode are likely to switch diagnoses to BD or schizoaffective disorder (Tohen et al, 2012), particularly if this occurs before age 30 (Akiskal et al, 1995;Goldberg, Harrow, & Whiteside, 2001). Psychotic features in bipolar depression are associated with worse suicidality and worse functioning (Caldieraro et al, 2017). There is a dearth of information to guide the treatment of psychotic bipolar depressive episodes (Yatham et al, 2013).…”

mentioning

confidence: 99%