Psychotic and affective symptoms of early-onset bipolar disorder: an observational study of patients in first manic episode

Psychotic and affective symptoms of early-onset bipolar disorder: an observational study of patients in first manic episode

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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 Application of QVP Method to Winter Precipitation Observation Based on Polarimetric Radar 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 Estimated prevalence of Echinococcus multilocularis in rac-coon dogs Nyctereutes procyonoides in northern Branden-burg, Germany 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.