First psychotic episode and predictors of bipolar disorder progression

Introduction Many studies on the identification and early treatment of psychotic disorders have focussed less on a solution to the issue of the evolution of an acute psychosis. Objective To identify some predictive elements of an evolution to bipolar disorder during a first psychotic episode. Methods We proceed with a retrospective study concerning 55 patients having developed a first psychotic episode and admitted in the psychiatry B department during the period extending between January 2010 and December 2015. Data were collected on a predetermined questionnaire exploring the following items (socio-demographic data, personal and psychiatric family antecedent, prodromes and psychotic episode symptomatology). Results Our sample was composed by 55 patients divided into 74% ( n  = 41) men and 26% ( n  = 14) women with a mean age of 26.5 ± 6.27 years. The evolution to a bipolar mood disorder concerned 22% of patients. The prodromal phase was always present. Prodromes correlated with progression to bipolar disorder are: thymic symptoms 44.1% of patients ( P  = 0.001), modification of volition 42.9% ( P  = 0.05), anger/irritability 66.7% ( P  = 0.032) and sadness 83.3% of patients ( P  = 0.05). Psychotic episode's symptoms correlated with the evolution towards a bipolar disorder corresponded to thymic symptoms. The latter was present in 44.1% of patients ( P  = 0.01). Conclusion Through our study, we were able to identify some factors positively correlated with a progression towards bipolarity during a first psychotic disorder. So it would be important to monitor closely and to educate our patients and their families about the evolutionary potential of a first psychotic episode.