{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,6]],"date-time":"2025-08-06T13:09:00Z","timestamp":1754485740416},"reference-count":22,"publisher":"Royal College of Psychiatrists","issue":"5","license":[{"start":{"date-parts":[[2018,1,3]],"date-time":"2018-01-03T00:00:00Z","timestamp":1514937600000},"content-version":"unspecified","delay-in-days":6638,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Br J Psychiatry"],"published-print":{"date-parts":[[1999,11]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Axis I comorbidities are prevalent among patients with severe bipolar disorder but the clinical and psychopathological implications are not clear.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>To investigate characteristics of four groups of patients categorised as follows: substance abuse only (group I), substance abuse associated with other Axis I disorders (group 2), non-substance-abuse Axis I comorbidity (group 3), no psychiatric comorbidity (group 4)<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>Consecutive patients with bipolar disorder with psychotic features (<jats:italic>n<\/jats:italic>=125) were assessed using the Structured Clinical Interview for DSM\u2013III\u2013R \u2013 patient version, and several psychopathological scales.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>By comparison with group 4, group I had a higher risk of having mood-incongruent delusions, group 2 had an earlier age at onset of mood disorder, a more frequent onset with a mixed state and a higher risk of suicide, and group 3 had more severe anxiety and a better awareness of illness.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Substance abuse, non-substance-abuse Axis I comorbidity and their reciprocal association are associated with different characteristics of bipolar disorder.<\/jats:p><\/jats:sec>","DOI":"10.1192\/bjp.175.5.467","type":"journal-article","created":{"date-parts":[[2008,10,15]],"date-time":"2008-10-15T05:41:36Z","timestamp":1224049296000},"page":"467-471","source":"Crossref","is-referenced-by-count":57,"title":["Axis I comorbidity in bipolar disorder with psychotic 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