Psychotic versus non-psychotic bipolar II disorder.
BACKGROUND
Psychotic symptoms in bipolar II disorder, allowed by definition only during a depressive episode, are present in a range between 3% and 45%. Little is known regarding the impact of psychotic symptoms on the clinical course of bipolar II patients. Findings from previous reports are controversial and focused specifically on bipolar I disorder. The aim of this study was to ascertain the clinical characteristics of individuals with bipolar II disorder with and without lifetime history of psychotic symptoms.


METHODS
The sample consisted of 164 DSM-IV Bipolar II patients consecutively recruited from the Barcelona Bipolar Disorder Program. Patients were divided in Bipolar II patients with (N=32) and without (N=132) lifetime history of psychotic symptoms. Clinical and sociodemographic features were compared.


RESULTS
Thirty-two out of 164 patients with bipolar II disorder had a history of psychosis during depression (19.5%). Bipolar II patients with a history of psychotic symptoms showed a higher number of hospitalizations than patients without such a history (p<0.001). They were also older but were less likely to have a family history of bipolar illness and any mental disorder than non-psychotic bipolar II patients. Melancholic and catatonic features were significantly more frequent in psychotic bipolar II patients (p<0.001).


CONCLUSIONS
Our findings confirm that the presence of psychotic symptoms in bipolar II disorder is not rare. Psychotic bipolar II disorder may be a different phenotype from non-psychotic bipolar disorder.
Mazzarini
Lorenzo
L
Bipolar Disorders Programme, Institute of Clinical Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain.
Colom
Francesc
F
Pacchiarotti
Isabella
I
Nivoli
Alessandra M A
AM
Murru
Andrea
A
Bonnin
C Mar
CM
Cruz
Nuria
N
Sanchez-Moreno
Jose
J
Kotzalidis
Giorgio D
GD
Girardi
Paolo
P
Tatarelli
Roberto
R
Vieta
Eduard
E
D000328:Adult; D000341:Affective Disorders, Psychotic / Q000175:diagnosis / Q000235:genetics / Q000523:psychology*; D017668:Age of Onset; D001714:Bipolar Disorder / Q000175:diagnosis / Q000235:genetics / Q000523:psychology*; D016009:Chi-Square Distribution; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012959:Socioeconomic Factors