BACKGROUND: Psychotic features in the context of major depressive syndromes have correlates in symptom severity, acute treatment response and long-term prognosis. Little is known as to whether psychotic features have similar importance when they occur within manic syndromes. METHODS: These data derive from a multi-center, long-term follow-up of patients with major affective disorder. Raters conducted follow-up interviews at 6-month intervals for the first 5 years and annually thereafter. A sub-set of probands participated in a family study in which all available, adult, first-degree relatives were interviewed as well. RESULTS: Of 139 who entered the study in an episode of mania, 90 patients had psychotic features. Symptom severity ratings at intake were more severe for this group. Though time to first recovery and time to first relapse did not distinguish the groups, psychotic features were associated with a greater number of weeks ill during follow-up and the strength of this association was similar to that seen for psychotic features within depressed patients described in an earlier publication. Patients with psychotic mania at intake did not differ significantly from those with nonpsychotic mania by response to acute lithium treatment, suicidal behavior during follow-up, or risks for affective disorder among first-degree relatives. Psychotic features within manic syndromes were not associated with high psychosis ratings during follow-up. In contrast, when psychotic features accompanied depressive syndromes, they strongly predicted the number of weeks with psychosis during follow-up, particularly among individuals whose episodes at intake were less acute. CONCLUSIONS: As with major depressive syndromes, psychotic features in mania are associated with greater symptom severity and higher morbidity in the long-term. Psychotic features are much less predictive of future psychosis when they occur within a manic syndrome than when they occur within a depressive syndrome.
BACKGROUND:Psychotic features in the context of major depressive syndromes have correlates in symptom severity, acute treatment response and long-term prognosis. Little is known as to whether psychotic features have similar importance when they occur within manic syndromes. METHODS: These data derive from a multi-center, long-term follow-up of patients with major affective disorder. Raters conducted follow-up interviews at 6-month intervals for the first 5 years and annually thereafter. A sub-set of probands participated in a family study in which all available, adult, first-degree relatives were interviewed as well. RESULTS: Of 139 who entered the study in an episode of mania, 90 patients had psychotic features. Symptom severity ratings at intake were more severe for this group. Though time to first recovery and time to first relapse did not distinguish the groups, psychotic features were associated with a greater number of weeks ill during follow-up and the strength of this association was similar to that seen for psychotic features within depressedpatients described in an earlier publication. Patients with psychotic mania at intake did not differ significantly from those with nonpsychotic mania by response to acute lithium treatment, suicidal behavior during follow-up, or risks for affective disorder among first-degree relatives. Psychotic features within manic syndromes were not associated with high psychosis ratings during follow-up. In contrast, when psychotic features accompanied depressive syndromes, they strongly predicted the number of weeks with psychosis during follow-up, particularly among individuals whose episodes at intake were less acute. CONCLUSIONS: As with major depressive syndromes, psychotic features in mania are associated with greater symptom severity and higher morbidity in the long-term. Psychotic features are much less predictive of future psychosis when they occur within a manic syndrome than when they occur within a depressive syndrome.
Authors: S Calugi; G B Cassano; A Litta; P Rucci; A Benvenuti; M Miniati; L Lattanzi; V Mantua; V Lombardi; A Fagiolini; E Frank Journal: J Affect Disord Date: 2010-09-15 Impact factor: 4.839
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Authors: Cagri Yüksel; Julie McCarthy; Ann Shinn; Danielle L Pfaff; Justin T Baker; Stephan Heckers; Perry Renshaw; Dost Ongür Journal: Schizophr Res Date: 2012-03-21 Impact factor: 4.939
Authors: Mei-Hua Hall; Deborah L Levy; Dean F Salisbury; Steve Haddad; Patience Gallagher; Mary Lohan; Bruce Cohen; Dost Ongür; Jordan W Smoller Journal: Am J Med Genet B Neuropsychiatr Genet Date: 2013-11-08 Impact factor: 3.568
Authors: Amit Shalev; John Merranko; Mary Kay Gill; Tina Goldstein; Fangzi Liao; Benjamin I Goldstein; Heather Hower; Neal Ryan; Michael Strober; Satish Iyengar; Martin Keller; Shirley Yen; Lauren M Weinstock; David Axelson; Boris Birmaher Journal: Bipolar Disord Date: 2019-12-17 Impact factor: 6.744
Authors: Rafael T de Sousa; Joao V Busnello; Orestes V Forlenza; Marcus V Zanetti; Marcio G Soeiro-de-Souza; Martinus T van de Bilt; Ricardo A Moreno; Carlos A Zarate; Wagner F Gattaz; Rodrigo Machado-Vieira Journal: J Psychiatr Res Date: 2012-09-20 Impact factor: 4.791