Prediction of outcome in mania by mood-congruent or mood-incongruent psychotic features.
OBJECTIVE
The aim of this study was to determine the significance of mood congruence of psychotic features in mania as a predictor of outcome.


METHODS
Fifty-four patients with bipolar disorder were followed prospectively for 4 years after recovery from an episode of mania with psychotic features. Assessments of residential and occupational status, interepisode symptoms, and episode recurrences were made at 6 and 48 months after recovery. Categorical outcomes were evaluated by logistic regression and recurrence risk with survival analysis.


RESULTS
Mood-incongruent psychotic features during the index manic episode predicted a shorter time in remission at 4 years (hazard ratio = 2.6), and Schneiderian first-rank symptoms predicted poor residential status at 4 years (odds ratio = 20.1).


CONCLUSIONS
Differentiation of mood congruence of psychotic features in mania evidently has prognostic validity and, therefore, has utility as a nosological characteristic.
Tohen
M
M
Department of Psychiatry, Harvard Medical School, Boston, MA.
Tsuang
M T
MT
Goodwin
D C
DC
D000328:Adult; D001714:Bipolar Disorder / Q000145:classification / Q000175:diagnosis* / Q000523:psychology; D003702:Delusions / Q000523:psychology; D004651:Employment; D005260:Female; D005500:Follow-Up Studies; D006212:Hallucinations / Q000175:diagnosis / Q000523:psychology; D006801:Humans; D008297:Male; D016017:Odds Ratio; D011336:Probability; D011379:Prognosis; D016016:Proportional Hazards Models; D011569:Psychiatric Status Rating Scales; D012008:Recurrence; D012111:Residence Characteristics; D012737:Sex Factors; D016019:Survival Analysis