{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T06:37:52Z","timestamp":1790491072358,"version":"4.1.0"},"reference-count":31,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2017,8,23]],"date-time":"2017-08-23T00:00:00Z","timestamp":1503446400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["5KL2TR000434"],"award-info":[{"award-number":["5KL2TR000434"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000025","name":"National Institute of Mental Health","doi-asserted-by":"publisher","award":["K23MH108823"],"award-info":[{"award-number":["K23MH108823"]}],"id":[{"id":"10.13039\/100000025","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Bipolar Disorders"],"published-print":{"date-parts":[[2018,2]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>Although there is a common clinical assumption that bipolar disorder with psychotic features reflects greater severity than bipolar disorder without psychosis, the existing empirical literature is mixed. This study investigated the phenomenology of psychosis as well as demographic, clinical, functional, and neuropsychological features in a large, cross\u2010sectional sample of participants with bipolar disorder divided by history of psychosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In a large single study, 168 affective\u2010only bipolar disorder (<jats:styled-content style=\"fixed-case\">BP<\/jats:styled-content>\u2010A) participants and 213 bipolar disorder with a history of psychosis (<jats:styled-content style=\"fixed-case\">BP<\/jats:styled-content>\u2010P) participants completed a comprehensive clinical diagnostic interview and neuropsychological testing. <jats:italic>t<\/jats:italic> tests, chi\u2010square tests, and Bayes factors were used to investigate group differences or lack thereof.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The prevalence of psychosis in this sample (53%) was similar to published reports. Nearly half of <jats:styled-content style=\"fixed-case\">BP<\/jats:styled-content>\u2010P participants experienced grandiose delusions, and relatively few endorsed \u201cfirst\u2010rank\u201d hallucinations of running commentary or two or more voices conversing. There were no demographic or neuropsychological differences between groups. <jats:styled-content style=\"fixed-case\">BP<\/jats:styled-content>\u2010A participants experienced greater chronicity of affective symptoms and a greater degree of rapid cycling than <jats:styled-content style=\"fixed-case\">BP<\/jats:styled-content>\u2010P participants; there were no other clinical differences between groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Overall, these results contradict the conventional notion that bipolar disorder with psychotic features represents a more severe illness than bipolar disorder without a history of psychosis. The presence of psychosis does not appear to be associated with poorer clinical\/functional outcome or suggest a greater degree of neuropsychological impairment; conversely, the absence of psychosis was associated with affective chronicity and rapid cycling. Nosological and treatment implications are discussed.<\/jats:p><\/jats:sec>","DOI":"10.1111\/bdi.12527","type":"journal-article","created":{"date-parts":[[2017,8,23]],"date-time":"2017-08-23T12:23:01Z","timestamp":1503490981000},"page":"18-26","source":"Crossref","is-referenced-by-count":42,"title":["Psychosis in bipolar disorder: Does it represent a more \u201csevere\u201d illness?"],"prefix":"10.1111","volume":"20","author":[{"given":"Cynthia Z","family":"Burton","sequence":"first","affiliation":[{"name":"Department of Psychiatry University of Michigan  Ann Arbor MI USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelly A","family":"Ryan","sequence":"additional","affiliation":[{"name":"Department of Psychiatry University of Michigan  Ann Arbor MI USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masoud","family":"Kamali","sequence":"additional","affiliation":[{"name":"Department of Psychiatry University of Michigan  Ann Arbor MI USA"},{"name":"Massachusetts General Hospital  Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David F","family":"Marshall","sequence":"additional","affiliation":[{"name":"Department of Psychiatry University of Michigan  Ann Arbor MI USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gloria","family":"Harrington","sequence":"additional","affiliation":[{"name":"Department of Psychiatry University of Michigan  Ann Arbor MI USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melvin G","family":"McInnis","sequence":"additional","affiliation":[{"name":"Department of Psychiatry University of Michigan  Ann Arbor MI USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ivy F","family":"Tso","sequence":"additional","affiliation":[{"name":"Department of Psychiatry University of Michigan  Ann Arbor MI USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,8,23]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291714000944"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.4088\/JCP.12m07788"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.2016.15101293"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11920-000-0069-4"},{"key":"e_1_2_7_6_1","volume-title":"Diagnostic and Statistical Manual of Mental Disorders","author":"American Psychiatric Association","year":"1994"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.books.9780890425596"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.158.8.1258"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.160.4.680"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2010.02.117"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/bdi.12061"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0010-440X(03)00089-0"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/bdi.12377"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/bdi.12485"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.1994.03950110009002"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2009.08.018"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-5618.2012.01032.x"},{"key":"e_1_2_7_18_1","unstructured":"MoreyRD RouderJN.BayesFactor: computation of bayes factors for common designs. 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