Affective syndromes, psychotic features, and prognosis. II. Mania.
Fifty-six patients with mania and psychotic features and 14 with schizoaffective disorder, manic type, were followed up with biannual assessments during a 5-year period. Results were treated as they were in an analogous follow-up of patients with psychotic major depression or schizoaffective disorder, depressed type. Patients with schizoaffective mania experienced more morbidity during follow-up than did patients with psychotic mania. Among patients with schizoaffective mania, those with a chronic subtype did far worse than did the others, while the mainly schizophrenic--mainly affective distinction was not predictive. When depressed and manic groups were combined (n = 173), the following baseline variables were significant independent predictors of a sustained delusional outcome: longer duration of the index episode, temporal dissociation between psychotic features and affective symptoms, and impaired adolescent friendship pattern.
Coryell
W
W
National Institute of Mental Health Collaborative Program on the Psychobiology of Depression-Clinical Studies, Bethesda, Md.
Keller
M
M
Lavori
P
P
Endicott
J
J
D000328:Adult; D000367:Age Factors; D001714:Bipolar Disorder / Q000175:diagnosis* / Q000523:psychology; D002908:Chronic Disease; D003702:Delusions / Q000175:diagnosis / Q000523:psychology; D003866:Depressive Disorder / Q000175:diagnosis / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization; D006801:Humans; D008297:Male; D008393:Marriage; D011379:Prognosis; D011569:Psychiatric Status Rating Scales; D000297:Psychology, Adolescent; D011618:Psychotic Disorders / Q000175:diagnosis* / Q000523:psychology; D012559:Schizophrenia / Q000175:diagnosis; D012565:Schizophrenic Psychology; D012917:Social Adjustment