Psychotic symptoms in patients with bipolar mania.
BACKGROUND
Psychosis has been identified in as many as 68% of patients with bipolar mania. This analysis identified psychotic symptoms in these patients.


METHODS
Data were from two placebo-controlled, 3-week studies in patients with an acute episode of bipolar mania. Symptoms were identified by the 30-item Positive and Negative Syndrome Scale (PANSS; item ratings, 1 = absent to 7 = extremely severe), the Young Mania Rating Scale, and the Global Assessment Scale.


RESULTS
Psychotic features at study entry were diagnosed in 264 (51.3%) of the 515 patients. At baseline, these patients had significantly more severe scores on the PANSS, Young Mania Rating Scale, and Global Assessment Scale than patients without psychotic features. Patients with psychotic features had mean (+/-SD) scores of mild (3) or greater on six PANSS items: grandiosity (4.5+/-1.4), delusions (4.4+/-1.4), lack of judgment/insight (4.1+/-1.5), excitement (3.9+/-1.3), suspiciousness/persecution (3.1+/-1.6), and hostility (3.1+/-1.5). Grandiosity symptoms of delusional proportions (scores > or = 4) were noted in 205 (78%) of patients with a diagnosis of psychotic features and in 113 (45%) patients without the diagnosis.


CONCLUSIONS
The study was not specifically designed to assess patients with psychotic features and the PANSS was developed to evaluate symptoms of schizophrenia.


CONCLUSIONS
These findings support prior reports indicating high rates of psychosis in patients with bipolar mania and identify the most prominent symptoms in these patients.
Canuso
Carla M
CM
Ortho-McNeil Janssen Scientific Affairs, L.L.C., Titusville, New Jersey 08560, United States. ccanuso@omjus.jnj.com
Bossie
Cynthia A
CA
Zhu
Young
Y
Youssef
Eriene
E
Dunner
David L
DL
D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D001714:Bipolar Disorder / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology*; D015897:Comorbidity; D039721:Diagnostic and Statistical Manual of Mental Disorders; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D010352:Patient Dropouts; D010919:Placebos; D015995:Prevalence; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D011594:Psychometrics; D011618:Psychotic Disorders / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology*; D011619:Psychotropic Drugs / Q000627:therapeutic use; D012307:Risk Factors; D018967:Risperidone / Q000627:therapeutic use; D012720:Severity of Illness Index
D010919:Placebos; D011619:Psychotropic Drugs; D018967:Risperidone