{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T01:39:52Z","timestamp":1790559592853,"version":"4.1.0"},"reference-count":105,"publisher":"Cambridge University Press (CUP)","issue":"13","license":[{"start":{"date-parts":[[2022,8,26]],"date-time":"2022-08-26T00:00:00Z","timestamp":1661472000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Psychol. Med."],"published-print":{"date-parts":[[2022,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Psychotic symptoms, that we defined as delusions or hallucinations, are common in bipolar disorders (BD). This systematic review and meta-analysis aims to synthesise the literature on both lifetime and point prevalence rates of psychotic symptoms across different BD subtypes, including both BD type I (BDI) and BD type II (BDII). We performed a systematic search of Medline, PsycINFO, Embase and Cochrane Library until 5 August 2021. Fifty-four studies (<jats:italic>N<\/jats:italic>= 23 461) of adults with BD met the predefined inclusion criteria for evaluating lifetime prevalence, and 24 studies (<jats:italic>N<\/jats:italic>= 6480) for evaluating point prevalence. Quality assessment and assessment of publication bias were performed. Prevalence rates were calculated using random effects meta-analysis, here expressed as percentages with a 95% confidence interval (CI). In studies of at least moderate quality, the pooled lifetime prevalence of psychotic symptoms in BDI was 63% (95% CI 57.5\u201368) and 22% (95% CI 14\u201333) in BDII. For BDI inpatients, the pooled lifetime prevalence was 71% (95% CI 61\u201379). There were no studies of community samples or inpatient BDII. The pooled point prevalence of psychotic symptoms in BDI was 54% (95 CI 41\u201367). The point prevalence was 57% (95% CI 47\u201366) in manic episodes and 13% (95% CI 7\u201323.5) in depressive episodes. There were not enough studies in BDII, BDI depression, mixed episodes and outpatient BDI. The pooled prevalence of psychotic symptoms in BDI may be higher than previously reported. More studies are needed for depressive and mixed episodes and community samples.<\/jats:p><jats:p>Prospero registration number: CRD 42017052706.<\/jats:p>","DOI":"10.1017\/s003329172200201x","type":"journal-article","created":{"date-parts":[[2022,8,26]],"date-time":"2022-08-26T05:45:25Z","timestamp":1661492725000},"page":"2413-2425","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":64,"title":["Lifetime and point prevalence of psychotic symptoms in adults with bipolar disorders: a systematic review and meta-analysis"],"prefix":"10.1017","volume":"52","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9882-5681","authenticated-orcid":false,"given":"S. R.","family":"Aminoff","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"I. N.","family":"Onyeka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"\u00d8degaard","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"Simonsen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T. V.","family":"Lagerberg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"O. A.","family":"Andreassen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K. L.","family":"Romm","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"I.","family":"Melle","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2022,8,26]]},"reference":[{"key":"S003329172200201X_ref22","doi-asserted-by":"publisher","DOI":"10.1111\/bdi.12527"},{"key":"S003329172200201X_ref44","doi-asserted-by":"publisher","DOI":"10.1016\/j.pnpbp.2010.03.008"},{"key":"S003329172200201X_ref13","doi-asserted-by":"publisher","DOI":"10.1159\/000170391"},{"key":"S003329172200201X_ref77","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2011.03.037"},{"key":"S003329172200201X_ref87","doi-asserted-by":"publisher","DOI":"10.1111\/bdi.12664"},{"key":"S003329172200201X_ref27","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2006.02.009"},{"key":"S003329172200201X_ref75","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpsychores.2021.110478"},{"key":"S003329172200201X_ref19","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2017.12.057"},{"key":"S003329172200201X_ref68","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2012.02.025"},{"key":"S003329172200201X_ref91","doi-asserted-by":"publisher","DOI":"10.1093\/schbul\/sbp034"},{"key":"S003329172200201X_ref96","doi-asserted-by":"publisher","DOI":"10.1016\/j.comppsych.2015.07.018"},{"key":"S003329172200201X_ref64","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-5618.2004.00140.x"},{"key":"S003329172200201X_ref72","doi-asserted-by":"publisher","DOI":"10.1590\/2237-6089-2012-0048"},{"key":"S003329172200201X_ref85","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2014.02.023"},{"key":"S003329172200201X_ref33","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2003.10.002"},{"key":"S003329172200201X_ref49","doi-asserted-by":"crossref","first-page":"878","DOI":"10.1002\/ajmg.b.31051","article-title":"A systematic association mapping on chromosome 6q in bipolar affective disorder \u2013 Evidence for the melanin-concentrating-hormone-receptor-2 gene as a risk factor for bipolar affective disorder","volume":"153","author":"Jamra","year":"2010","journal-title":"American Journal of Medical Genetics, Part B: Neuropsychiatric Genetics"},{"key":"S003329172200201X_ref55","doi-asserted-by":"publisher","DOI":"10.1159\/000113006"},{"key":"S003329172200201X_ref43","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2016.10.012"},{"key":"S003329172200201X_ref67","doi-asserted-by":"publisher","DOI":"10.1097\/JCP.0000000000000867"},{"key":"S003329172200201X_ref16","doi-asserted-by":"publisher","DOI":"10.1093\/schbul\/sbab061"},{"key":"S003329172200201X_ref11","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2020.03.083"},{"key":"S003329172200201X_ref23","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2017.03.059"},{"key":"S003329172200201X_ref31","doi-asserted-by":"publisher","DOI":"10.1159\/000511348"},{"key":"S003329172200201X_ref41","doi-asserted-by":"publisher","DOI":"10.4088\/JCP.09m05483yel"},{"key":"S003329172200201X_ref97","doi-asserted-by":"publisher","DOI":"10.1007\/s00406-010-0186-y"},{"key":"S003329172200201X_ref5","unstructured":"Aminoff, S. , Melle, I. , \u00d8degaard, M. , & Onyeka, I. (2017). The prevalence of psychotic symptoms in adults with bipolar disorder: a systematic review and meta-analysis."},{"key":"S003329172200201X_ref78","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2013.05.018"},{"key":"S003329172200201X_ref84","doi-asserted-by":"publisher","DOI":"10.1097\/PRA.0000000000000392"},{"key":"S003329172200201X_ref92","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2011.07.027"},{"key":"S003329172200201X_ref45","doi-asserted-by":"publisher","DOI":"10.5152\/npa.2015.7180"},{"key":"S003329172200201X_ref15","doi-asserted-by":"publisher","DOI":"10.15537\/smj.2016.3.13108"},{"key":"S003329172200201X_ref28","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2015.09.001"},{"key":"S003329172200201X_ref70","doi-asserted-by":"publisher","DOI":"10.1590\/S1516-44462009000200006"},{"key":"S003329172200201X_ref39","doi-asserted-by":"publisher","DOI":"10.1016\/S0165-0327(99)00025-7"},{"key":"S003329172200201X_ref56","doi-asserted-by":"publisher","DOI":"10.1016\/S0924-9338(99)80742-1"},{"key":"S003329172200201X_ref81","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajp.2017.01.006"},{"key":"S003329172200201X_ref88","doi-asserted-by":"publisher","DOI":"10.1016\/j.psyneuen.2014.11.015"},{"key":"S003329172200201X_ref60","doi-asserted-by":"publisher","DOI":"10.1016\/j.pnpbp.2011.04.006"},{"key":"S003329172200201X_ref95","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpsychires.2019.10.005"},{"key":"S003329172200201X_ref20","volume-title":"Comprehensive meta-analysis (version 3)","author":"Borenstein","year":"2013"},{"key":"S003329172200201X_ref99","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291717000307"},{"key":"S003329172200201X_ref104","doi-asserted-by":"publisher","DOI":"10.1001\/archgenpsychiatry.2007.43"},{"key":"S003329172200201X_ref53","doi-asserted-by":"publisher","DOI":"10.1016\/S0165-0327(03)00191-5"},{"key":"S003329172200201X_ref46","doi-asserted-by":"publisher","DOI":"10.1111\/bdi.12539"},{"key":"S003329172200201X_ref47","doi-asserted-by":"publisher","DOI":"10.1111\/acps.13062"},{"key":"S003329172200201X_ref74","doi-asserted-by":"publisher","DOI":"10.1177\/0004867412440191"},{"key":"S003329172200201X_ref57","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2020.09.055"},{"key":"S003329172200201X_ref80","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-5618.2009.00734.x"},{"key":"S003329172200201X_ref6","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2014.04.050"},{"key":"S003329172200201X_ref83","doi-asserted-by":"publisher","DOI":"10.1177\/2045125318769235"},{"key":"S003329172200201X_ref89","doi-asserted-by":"publisher","DOI":"10.1177\/0004867415594427"},{"key":"S003329172200201X_ref51","doi-asserted-by":"publisher","DOI":"10.1016\/j.comppsych.2010.08.004"},{"key":"S003329172200201X_ref98","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-5618.2011.00934.x"},{"key":"S003329172200201X_ref100","volume-title":"The Newcastle\u2013Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses","author":"Wells","year":"2000"},{"key":"S003329172200201X_ref102","volume-title":"International statistical classification of diseases and related health problems","year":"2020"},{"key":"S003329172200201X_ref103","doi-asserted-by":"publisher","DOI":"10.1016\/S0165-0327(98)00216-X"},{"key":"S003329172200201X_ref18","doi-asserted-by":"publisher","DOI":"10.3390\/jcm8071046"},{"key":"S003329172200201X_ref58","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2020.12.184"},{"key":"S003329172200201X_ref8","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2015.04.037"},{"key":"S003329172200201X_ref90","doi-asserted-by":"publisher","DOI":"10.1590\/S1516-44462006005000036"},{"key":"S003329172200201X_ref14","doi-asserted-by":"publisher","DOI":"10.1159\/000049285"},{"key":"S003329172200201X_ref10","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2004.08.012"},{"key":"S003329172200201X_ref4","volume-title":"Diagnostic and statistical manual of mental disorders","year":"2013"},{"key":"S003329172200201X_ref50","doi-asserted-by":"publisher","DOI":"10.1176\/jnp.2010.22.1.55"},{"key":"S003329172200201X_ref35","doi-asserted-by":"publisher","DOI":"10.1111\/bdi.12004"},{"key":"S003329172200201X_ref42","volume-title":"Manic-depressive illness. Bipolar disorders and recurrent depression","author":"Goodwin","year":"2007"},{"key":"S003329172200201X_ref25","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-5618.2007.00415.x"},{"key":"S003329172200201X_ref59","doi-asserted-by":"publisher","DOI":"10.1111\/acps.12363"},{"key":"S003329172200201X_ref62","doi-asserted-by":"publisher","DOI":"10.1159\/000128325"},{"key":"S003329172200201X_ref2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2018.07.051"},{"key":"S003329172200201X_ref66","doi-asserted-by":"publisher","DOI":"10.1001\/archgenpsychiatry.2011.12"},{"key":"S003329172200201X_ref69","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2007.05.026"},{"key":"S003329172200201X_ref71","doi-asserted-by":"publisher","DOI":"10.4088\/JCP.11m06936"},{"key":"S003329172200201X_ref82","doi-asserted-by":"publisher","DOI":"10.1016\/j.comppsych.2016.08.007"},{"key":"S003329172200201X_ref86","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291718001885"},{"key":"S003329172200201X_ref12","doi-asserted-by":"publisher","DOI":"10.1186\/s40345-017-0094-4"},{"key":"S003329172200201X_ref52","doi-asserted-by":"publisher","DOI":"10.1159\/000503928"},{"key":"S003329172200201X_ref37","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2016.02.005"},{"key":"S003329172200201X_ref93","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.2013.12121500"},{"key":"S003329172200201X_ref32","doi-asserted-by":"publisher","DOI":"10.1093\/schbul\/sbw080"},{"key":"S003329172200201X_ref94","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2009.04.009"},{"key":"S003329172200201X_ref101","volume-title":"International statistical classification of diseases and related health problems","year":"1992"},{"key":"S003329172200201X_ref36","doi-asserted-by":"publisher","DOI":"10.1080\/00332747.2016.1208002"},{"key":"S003329172200201X_ref30","doi-asserted-by":"publisher","DOI":"10.1053\/comp.2000.7432"},{"key":"S003329172200201X_ref65","doi-asserted-by":"publisher","DOI":"10.4088\/JCP.08m04408"},{"key":"S003329172200201X_ref79","doi-asserted-by":"publisher","DOI":"10.1111\/acps.13218"},{"key":"S003329172200201X_ref1","doi-asserted-by":"publisher","DOI":"10.1002\/brb3.1568"},{"key":"S003329172200201X_ref63","doi-asserted-by":"publisher","DOI":"10.1111\/bdi.12561"},{"key":"S003329172200201X_ref7","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2018.04.010"},{"key":"S003329172200201X_ref54","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.bp.112.113548"},{"key":"S003329172200201X_ref29","first-page":"138","article-title":"Plasma brain-derived neurotrophic factor in bipolar and unipolar depression","volume":"16","author":"Dell'Osso","year":"2010","journal-title":"Italian Journal of Psychopathology"},{"key":"S003329172200201X_ref38","doi-asserted-by":"publisher","DOI":"10.1186\/s12991-016-0101-7"},{"key":"S003329172200201X_ref73","unstructured":"\u00d8degaard, M. , & Aminoff, S. R. (2022). Search strategy for \u2018Lifetime and point prevalence of psychotic symptoms in adults with bipolar disorders: a systematic review and meta-analysis\u2019. (Publication no. DOI 10.17605\/OSF.IO\/QE362). From osf.io\/qe362."},{"key":"S003329172200201X_ref76","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2012.10.005"},{"key":"S003329172200201X_ref105","doi-asserted-by":"publisher","DOI":"10.5350\/DAJPN2015280407"},{"key":"S003329172200201X_ref9","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0447.2006.00841.x"},{"key":"S003329172200201X_ref61","doi-asserted-by":"publisher","DOI":"10.4088\/JCP.08m04663yel"},{"key":"S003329172200201X_ref40","doi-asserted-by":"publisher","DOI":"10.1016\/S0165-0327(03)00161-7"},{"key":"S003329172200201X_ref17","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2015.04.043"},{"key":"S003329172200201X_ref24","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2014.03.037"},{"key":"S003329172200201X_ref3","first-page":"10","article-title":"The comorbidity of anxiety disorders in bipolar I patients: Prevalence and clinical correlates","volume":"43","author":"Altindag","year":"2006","journal-title":"Israel Journal of Psychiatry and Related Sciences"},{"key":"S003329172200201X_ref48","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291717002501"},{"key":"S003329172200201X_ref26","doi-asserted-by":"publisher","DOI":"10.4088\/JCP.v62n07a09"},{"key":"S003329172200201X_ref34","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.2010.10030328"},{"key":"S003329172200201X_ref21","doi-asserted-by":"publisher","DOI":"10.1002\/9780470743386"}],"container-title":["Psychological Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S003329172200201X","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,11,26]],"date-time":"2023-11-26T05:51:42Z","timestamp":1700977902000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S003329172200201X\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,8,26]]},"references-count":105,"journal-issue":{"issue":"13","published-print":{"date-parts":[[2022,10]]}},"alternative-id":["S003329172200201X"],"URL":"https:\/\/doi.org\/10.1017\/s003329172200201x","relation":{},"ISSN":["0033-2917","1469-8978"],"issn-type":[{"value":"0033-2917","type":"print"},{"value":"1469-8978","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,8,26]]},"assertion":[{"value":"Copyright \u00a9 The Author(s), 2022. Published by Cambridge University Press","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http:\/\/creativecommons.org\/licenses\/by\/4.0\/), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}]}}