Prevalence of psychotic symptoms and their impact on course and outcome of patients with bipolar disorder: Findings from the Bipolar Disorder Course and Outcome study from India (BiD-CoIN study)

• Published in: Journal of affective disorders 2022-05, Vol.305, p.233-239
• Main Authors: Grover, Sandeep, Avasthi, Ajit, Chakravarty, Rahul, Dan, Amitava, Chakraborty, Kaustav, Neogi, Rajarshi, Desouza, Avinash, Nayak, Omkar, Kumar Praharaj, Samir, Menon, Vikas, Ramandeep, Bathla, Manish, Subramanyam, Alka A., Nebhinani, Naresh, Ghosh, Prasonjit, Lakdawala, Bhavesh, Bhattacharya, Ranjan
• Format: Article
• Language: English
• Subjects: Antipsychotic Agents - therapeutic use; Bipolar disorder; Bipolar Disorder - diagnosis; Bipolar Disorder - epidemiology; Bipolar Disorder - therapy; Child, Preschool; Correlates; Humans; Outcome Assessment, Health Care; Prevalence; Psychotic Disorders - diagnosis; Psychotic Disorders - epidemiology; Psychotic Disorders - therapy; Psychotic symptoms
• ISSN: 0165-0327; 1573-2517
• DOI: 10.1016/j.jad.2022.02.070

Most of the available data on the prevalence and impact of psychotic symptoms on the course of bipolar disorder (BD) is from Western countries. We aimed to study the prevalence of at least one psychotic episode in the lifetime in patients with BD and its association with the long-term course and outcome. 773 patients recruited as part of the Bipolar Disorder Course and Outcome study from India (BiD-CoIN study) were divided into 2 groups, based on the presence or absence of at least one psychotic episode in the lifetime. 326 (42.2%) patients had at least one psychotic episode in their lifetime. At least one psychotic episode in the lifetime was associated with overall more severe illness in terms of lower age of onset, a higher number of episodes in the first 5 years of illness; higher rates of BD-II, a higher rate of lifetime history of at least 1 suicide attempt, lifetime history of hospitalization, history of receiving Electroconvulsive Therapy, and a higher prescription rates of antipsychotics. However, presence of psychotics symptoms was associated with better cognitive functioning. Our findings suggest that the presence of psychotic symptoms during episodes in patients with BD is associated with poorer course of BD. •42.2% patients had at least one psychotic episode in their lifetime•Psychotic episodes are associated with overall more severe illness in terms of a higher number of lifetime episodes•Psychotic episodes are associated with a higher rate of lifetime history of at least 1 suicide attempt, poorer insight•Psychotic episodes are associated with higher disability in the work domain, and lifetime history of hospitalization•Psychotic episodes in the lifetime are associated with history of receiving ECT and higher prescription rates of antipsychotics