Psychotic and affective symptoms of early-onset bipolar disorder: an observational study of patients in first manic episode
Autor(a) principal: | |
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Data de Publicação: | 2020 |
Outros Autores: | , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Brazilian Journal of Psychiatry (São Paulo. 1999. Online) |
Texto Completo: | http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1516-44462020000200168 |
Resumo: | 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 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 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. |
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Brazilian Journal of Psychiatry (São Paulo. 1999. Online) |
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Psychotic and affective symptoms of early-onset bipolar disorder: an observational study of patients in first manic episodePsychosisbipolar disorderadolescentpsychopathologyprodromal symptoms 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 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 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.Associação Brasileira de Psiquiatria2020-04-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S1516-44462020000200168Brazilian Journal of Psychiatry v.42 n.2 2020reponame:Brazilian Journal of Psychiatry (São Paulo. 1999. Online)instname:Associação Brasileira de Psiquiatria (ABP)instacron:ABP10.1590/1516-4446-2019-0455info:eu-repo/semantics/openAccessFu-I,LeeGurgel,Wagner de S.Caetano,Sheila C.Machado-Vieira,RodrigoWang,Yuan P.eng2020-04-08T00:00:00Zoai:scielo:S1516-44462020000200168Revistahttp://www.bjp.org.br/ahead_of_print.asphttps://old.scielo.br/oai/scielo-oai.php||rbp@abpbrasil.org.br1809-452X1516-4446opendoar:2020-04-08T00:00Brazilian Journal of Psychiatry (São Paulo. 1999. Online) - Associação Brasileira de Psiquiatria (ABP)false |
dc.title.none.fl_str_mv |
Psychotic and affective symptoms of early-onset bipolar disorder: an observational study of patients in first manic episode |
title |
Psychotic and affective symptoms of early-onset bipolar disorder: an observational study of patients in first manic episode |
spellingShingle |
Psychotic and affective symptoms of early-onset bipolar disorder: an observational study of patients in first manic episode Fu-I,Lee Psychosis bipolar disorder adolescent psychopathology prodromal symptoms |
title_short |
Psychotic and affective symptoms of early-onset bipolar disorder: an observational study of patients in first manic episode |
title_full |
Psychotic and affective symptoms of early-onset bipolar disorder: an observational study of patients in first manic episode |
title_fullStr |
Psychotic and affective symptoms of early-onset bipolar disorder: an observational study of patients in first manic episode |
title_full_unstemmed |
Psychotic and affective symptoms of early-onset bipolar disorder: an observational study of patients in first manic episode |
title_sort |
Psychotic and affective symptoms of early-onset bipolar disorder: an observational study of patients in first manic episode |
author |
Fu-I,Lee |
author_facet |
Fu-I,Lee Gurgel,Wagner de S. Caetano,Sheila C. Machado-Vieira,Rodrigo Wang,Yuan P. |
author_role |
author |
author2 |
Gurgel,Wagner de S. Caetano,Sheila C. Machado-Vieira,Rodrigo Wang,Yuan P. |
author2_role |
author author author author |
dc.contributor.author.fl_str_mv |
Fu-I,Lee Gurgel,Wagner de S. Caetano,Sheila C. Machado-Vieira,Rodrigo Wang,Yuan P. |
dc.subject.por.fl_str_mv |
Psychosis bipolar disorder adolescent psychopathology prodromal symptoms |
topic |
Psychosis bipolar disorder adolescent psychopathology prodromal symptoms |
description |
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 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 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. |
publishDate |
2020 |
dc.date.none.fl_str_mv |
2020-04-01 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1516-44462020000200168 |
url |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1516-44462020000200168 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
10.1590/1516-4446-2019-0455 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
text/html |
dc.publisher.none.fl_str_mv |
Associação Brasileira de Psiquiatria |
publisher.none.fl_str_mv |
Associação Brasileira de Psiquiatria |
dc.source.none.fl_str_mv |
Brazilian Journal of Psychiatry v.42 n.2 2020 reponame:Brazilian Journal of Psychiatry (São Paulo. 1999. Online) instname:Associação Brasileira de Psiquiatria (ABP) instacron:ABP |
instname_str |
Associação Brasileira de Psiquiatria (ABP) |
instacron_str |
ABP |
institution |
ABP |
reponame_str |
Brazilian Journal of Psychiatry (São Paulo. 1999. Online) |
collection |
Brazilian Journal of Psychiatry (São Paulo. 1999. Online) |
repository.name.fl_str_mv |
Brazilian Journal of Psychiatry (São Paulo. 1999. Online) - Associação Brasileira de Psiquiatria (ABP) |
repository.mail.fl_str_mv |
||rbp@abpbrasil.org.br |
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1754212559222734848 |