Characteristics of mood-congruent and mood-incongruent psychotic features in bipolar disorder

Introduction
Psychotic features in patients with bipolar disorder (BD) have been poorly researched in the context of their relationship with the longitudinal course and demographic and clinical characteristics of the illness.

Material and methods
In a cross-sectional study of BD patients, comprehensive demographic and clinical characteristics were assessed using the Structured Clinical Instrument for DSM-IV-TR (SCID). Manic symptoms were assessed using Young’s Mania Rating Scale (YMRS), depressive symptoms by the Montgomery-Åsberg Depression Rating Scale (MADRS) and psychotic symptoms with the Scale for Assessment of Positive Symptoms (SAPS). The relationships between these characteristics and psychotic symptoms were analysed. The independent samples t-test was used to assess continuous variables, while the χ2 test was used to assess categorical data.

Results
Psychotic features were associated with BD in 48.94% of patients (n = 92 out of a total of 188 patients having BD). Of these, 45.74% (n = 86) had mood-congruent psychotic features and 3.19% (n = 6) had mood-incongruent psychotic features. All six patients who had mood-incongruent psychotic features had manic symptoms.

Conclusions
Our findings suggest that mood-congruent psychotic symptoms in BD are associated with a more severe, predominantly manic illness course. Mean age at onset was 27.76 (±8.54) years for patients with mood-congruent psychotic features and 28.00 (±11.08) years for patients with mood-incongruent psychotic features.