TY - JOUR
T1 - The characteristics of psychotic features in bipolar disorder
AU - Van Bergen, Annet H.
AU - Van Bergen, Annet H.
AU - Verkooijen, Sanne
AU - Vreeker, Annabel
AU - Abramovic, Lucija
AU - Hillegers, Manon H.
AU - Hillegers, Manon H.
AU - Spijker, Annet T.
AU - Hoencamp, Erik
AU - Hoencamp, Erik
AU - Regeer, Eline J.
AU - Knapen, Stefan E.
AU - Riemersma-Van Der Lek, Rixt F.
AU - Schoevers, Robert
AU - Stevens, Anja W.
AU - Schulte, Peter F.J.
AU - Vonk, Ronald
AU - Hoekstra, Rocco
AU - Van Beveren, Nico J.
AU - Kupka, Ralph W.
AU - Kupka, Ralph W.
AU - Sommer, Iris E.C.
AU - Ophoff, Roel A.
AU - Ophoff, Roel A.
AU - Kahn, René S.
AU - Kahn, René S.
AU - Boks, Marco P.M.
PY - 2019/9
Y1 - 2019/9
N2 - Background In a large and comprehensively assessed sample of patients with bipolar disorder type I (BDI), we investigated the prevalence of psychotic features and their relationship with life course, demographic, clinical, and cognitive characteristics. We hypothesized that groups of psychotic symptoms (Schneiderian, mood incongruent, thought disorder, delusions, and hallucinations) have distinct relations to risk factors.Methods In a cross-sectional study of 1342 BDI patients, comprehensive demographical and clinical characteristics were assessed using the Structured Clinical Interview for DSM-IV (SCID-I) interview. In addition, levels of childhood maltreatment and intelligence quotient (IQ) were assessed. The relationships between these characteristics and psychotic symptoms were analyzed using multiple general linear models.Results A lifetime history of psychotic symptoms was present in 73.8% of BDI patients and included delusions in 68.9% of patients and hallucinations in 42.6%. Patients with psychotic symptoms showed a significant younger age of disease onset (β =-0.09, t =-3.38, p = 0.001) and a higher number of hospitalizations for manic episodes (F11 338 = 56.53, p < 0.001). Total IQ was comparable between groups. Patients with hallucinations had significant higher levels of childhood maltreatment (β = 0.09, t = 3.04, p = 0.002).Conclusions In this large cohort of BDI patients, the vast majority of patients had experienced psychotic symptoms. Psychotic symptoms in BDI were associated with an earlier disease onset and more frequent hospitalizations particularly for manic episodes. The study emphasizes the strength of the relation between childhood maltreatment and hallucinations but did not identify distinct subgroups based on psychotic features and instead reported of a large heterogeneity of psychotic symptoms in BD.
AB - Background In a large and comprehensively assessed sample of patients with bipolar disorder type I (BDI), we investigated the prevalence of psychotic features and their relationship with life course, demographic, clinical, and cognitive characteristics. We hypothesized that groups of psychotic symptoms (Schneiderian, mood incongruent, thought disorder, delusions, and hallucinations) have distinct relations to risk factors.Methods In a cross-sectional study of 1342 BDI patients, comprehensive demographical and clinical characteristics were assessed using the Structured Clinical Interview for DSM-IV (SCID-I) interview. In addition, levels of childhood maltreatment and intelligence quotient (IQ) were assessed. The relationships between these characteristics and psychotic symptoms were analyzed using multiple general linear models.Results A lifetime history of psychotic symptoms was present in 73.8% of BDI patients and included delusions in 68.9% of patients and hallucinations in 42.6%. Patients with psychotic symptoms showed a significant younger age of disease onset (β =-0.09, t =-3.38, p = 0.001) and a higher number of hospitalizations for manic episodes (F11 338 = 56.53, p < 0.001). Total IQ was comparable between groups. Patients with hallucinations had significant higher levels of childhood maltreatment (β = 0.09, t = 3.04, p = 0.002).Conclusions In this large cohort of BDI patients, the vast majority of patients had experienced psychotic symptoms. Psychotic symptoms in BDI were associated with an earlier disease onset and more frequent hospitalizations particularly for manic episodes. The study emphasizes the strength of the relation between childhood maltreatment and hallucinations but did not identify distinct subgroups based on psychotic features and instead reported of a large heterogeneity of psychotic symptoms in BD.
KW - Childhood trauma
KW - cognitive functioning
KW - delusions
KW - formal thought disorder
KW - hallucinations
KW - mood incongruent symptoms
KW - psychosis
KW - Schneiderian symptoms
UR - http://www.scopus.com/inward/record.url?scp=85054989761&partnerID=8YFLogxK
U2 - 10.1017/S0033291718002854
DO - 10.1017/S0033291718002854
M3 - Article
AN - SCOPUS:85054989761
SN - 0033-2917
VL - 49
SP - 2036
EP - 2048
JO - Psychological Medicine
JF - Psychological Medicine
IS - 12
ER -