[First psychotic episode in bipolar disorder: clinical differentiation and functional impact in an Argentinean...

Bipolar disorder in its early phase results in a diagnostic and therapeutic challenge for the clinician. Individuals with bipolar disorder can be grouped according with their different clinical features such as the presence or absence of psychotic symptoms. Early illness detection and treatment is usually associated with a better prognosis.

The main objective of this study was to compare the clinical features, functionality and stigma of patients with bipolar disorder with psychotic symptoms at onset.

A total sample of 175 bipolar disorder outpatients completed clinical assessment (YMRS and HAM-D), functionality (FAST), and stigma (ISE) scales. All patients were clinically stable for at least three months and were following active maintenance treatment regimens.

The psychotic group consisted of 70 patients and the non-psychotic group 105 patients. Statistical significant differences were found between patients with and without psychotic features regarding sex, age at diagnosis, perceived stigma and functional impairment. Bipolar patients with psychotic symptoms at onset received an early treatment.

Clinical differences found in both groups of bipolar patients have therapeutic implications which may account for different outcomes. Differential interventions could be designed according to each clinical group. Special attention should be paid to bipolar first episode features.