title: Prodromes and coping types in bipolar patients with nonpsychotic or psychotic mania.
abstract: BACKGROUND
  Bipolar disorder is a recurrent and cyclical illness frequently accompanied by psychotic symptoms. Detecting prodromes and enhancing coping skills for prodromal symptoms in bipolar patients are very important for relapse prevention. Psychotic features in bipolar patients are related to poor prognosis. We aimed to investigate the differences in prodromal symptoms and coping styles in psychotic and nonpsychotic bipolar patients.
  
  
  METHODS
  Eighty-three euthymic bipolar patients with or without a history of manic psychosis were interviewed about their demographic, diagnostic, and clinical information and completed a 40-item checklist for prodromal symptoms. After the interview, they completed the Coping Inventory for Prodromes of Mania.
  
  
  RESULTS
  The differences between the psychotic patients and the nonpsychotic patients were found in the prodromal durations, and a few prodromal symptoms such as afraid of going crazy (P = .03), energetic-very active (P = .01), and hearing hallucination (P = .02). The psychotic patients showed a higher score of denial or blame than the nonpsychotic ones (1.92 ± 0.73 in nonpsychosis, 2.32 ± 0.84 in psychosis; P = .03). Logistic regression revealed that the duration of prodromes (P = .02) and hearing hallucination (P = .01) were related to the presence of psychotic features.
  
  
  CONCLUSIONS
  Psychotic patients had a tendency to use denial or blame coping strategy and to experience attenuated psychotic symptoms a little more during the prodromal period. Timely psychosocial approaches for detecting signs and enhancing coping strategies would improve the outcomes.
authors.affiliation: Department of Psychiatry, College of Medicine, Konyang University, Daejeon, South Korea.
authors.forename: Vin
authors.initials: V
authors.lastname: Ryu
authors.forename: Dong-Ho
authors.initials: DH
authors.lastname: Song
authors.forename: Rayeon
authors.initials: R
authors.lastname: Ha
authors.forename: Kyooseob
authors.initials: K
authors.lastname: Ha
authors.forename: Hyun-Sang
authors.initials: HS
authors.lastname: Cho
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D001714:Bipolar Disorder / Q000150:complications / Q000523:psychology*; D003717:Denial, Psychological; D005260:Female; D006212:Hallucinations / Q000150:complications / Q000523:psychology; D006801:Humans; D008297:Male; D008875:Middle Aged; D062706:Prodromal Symptoms; D011618:Psychotic Disorders / Q000150:complications / Q000523:psychology*; D012720:Severity of Illness Index