Objective: Previous studies have shown that there is a difference in severity between bipolar disorder with psychotic symptoms and without psychotic symptoms, there is higher incidence of cognitive impairment in the presence of psychotic symptoms.
Methods: 60 patients with bipolar disorder were selected from inpatient and outpatient clinics and interwieved with SCID-I. Information about illness is recorded on the follow up charts.
Results: 36 % of patients with bipolar disorders have an episode with psychotic symptoms (p=0.004). There are no difference in comorbidity, axis 2,3 and 4 diagnosis in both groups however incidence of axis 5 diagnosis is lower in psychotic group (p=0.005). Age at the onset of first episode, alcohol and substance use and presence of stressor before the episode are in similar incidence in both groups. Family history is more often in psychotic group (p=0.009). In psychotic group B12 levels were found lower (p=0.039). HAM-D scores in first 4 weeks, YMRS in first 2 weeks and CGI scores in first 6 weeks were seem to be higher in psychotic group. However, interestingly no difference have seen in SF-36 scores.
Conclusion: Psychotic symptos increases the severity of episode and this is correlated with the family history. Age at the beginning of the disease, episode frequency, switch etc. doesn’t seem to hve an effect on the characteristics of the disease. But the question if these factors have an effect during the follow up period is of wonder and can not be answered by the results of this study.