Axis I comorbidity in bipolar disorder with psychotic features.
BACKGROUND
Axis I comorbidities are prevalent among patients with severe bipolar disorder but the clinical and psychopathological implications are not clear.


OBJECTIVE
To investigate characteristics of four groups of patients categorised as follows: substance abuse only (group 1), substance abuse associated with other Axis I disorders (group 2), non-substance-abuse Axis I comorbidity (group 3), no psychiatric comorbidity (group 4).


METHODS
Consecutive patients with bipolar disorder with psychotic features (n = 125) were assessed using the Structured Clinical Interview for DSM-III-R--patient version, and several psychopathological scales.


RESULTS
By comparison with group 4, group 1 had a higher risk of having mood-incongruent delusions, group 2 had an earlier age at onset of mood disorder, a more frequent onset with a mixed state and a higher risk of suicide, and group 3 had more severe anxiety and a better awareness of illness.


CONCLUSIONS
Substance abuse, non-substance-abuse Axis I comorbidity and their reciprocal association are associated with different characteristics of bipolar disorder.
Pini
S
S
Department of Psychiatry, University of Pisa, Italy.
Dell'Osso
L
L
Mastrocinque
C
C
Marcacci
G
G
Papasogli
A
A
Vignoli
S
S
Pallanti
S
S
Cassano
G
G
D000328:Adult; D017668:Age of Onset; D000704:Analysis of Variance; D001008:Anxiety Disorders / Q000453:epidemiology; D001714:Bipolar Disorder / Q000453:epidemiology*; D015331:Cohort Studies; D015897:Comorbidity; D005260:Female; D006801:Humans; D008297:Male; D016584:Panic Disorder / Q000453:epidemiology; D010698:Phobic Disorders / Q000453:epidemiology*; D012044:Regression Analysis; D013001:Somatoform Disorders / Q000453:epidemiology; D019966:Substance-Related Disorders / Q000453:epidemiology*