Psychotic and affective symptoms of early-onset bipolar disorder: an observational study of patients in first manic episode
Braz. J. Psychiatry (São Paulo, 1999, Impr.)
;
42(2): 168-174, Mar.-Apr. 2020. tab, graf
Article
in English
| LILACS
| ID: biblio-1089242
ABSTRACT
Objective:
Presence of psychotic symptoms seems to be a commonplace in early-onset bipolar disorder (BD). However, few studies have examined their occurrence in adolescent-onset BD. We sought to investigate the frequency of affective and psychotic symptoms observed during the first manic episode in adolescents.Methods:
Forty-nine adolescents with bipolar I disorder (DSM-IV criteria) were admitted to a psychiatric hospital during their first acute manic episode. Assessment for current psychiatric diagnosis was performed by direct clinical interview and the DSM-IV version of the Diagnostic Interview for Children and Adolescents (DICA).Results:
Teenage inpatients with BD consistently exhibited typical manic features, such as euphoria, grandiosity, and psychomotor agitation. In addition, disorganization and psychotic symptoms were present in 82 and 55% of the total sample, respectively. There was no significant difference in symptoms between early- and late-adolescent subgroups. Remarkably, most patients (76%) reported previous depressive episode(s); of these, 47% had prominent psychotic features in the prior depressive period.Conclusion:
These findings suggest that disorganization and psychotic symptoms during the first manic episode are salient features in adolescent-onset BD, and that psychotic depression frequently may precede psychotic mania. Nevertheless, differential diagnosis with schizophrenia should be routinely ruled out in cases of early-onset first psychotic episode.
Full text:
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Index:
LILACS (Americas)
Main subject:
Psychotic Disorders
/
Bipolar Disorder
/
Affective Symptoms
Type of study:
Diagnostic study
/
Observational study
/
Qualitative research
Limits:
Adolescent
/
Child
/
Female
/
Humans
/
Male
Language:
English
Journal:
Braz. J. Psychiatry (São Paulo, 1999, Impr.)
Journal subject:
Psychiatry
Year:
2020
Type:
Article
Affiliation country:
Brazil
/
United States
Institution/Affiliation country:
Faculdade de Medicina, Universidade de São Paulo (USP)/BR
/
Universidade Federal de São Paulo (UNIFESP)/BR
/
University of Texas Health Science Center/US
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