Psychosis

The presence of psychotic features in the course of MDI is a well-known phenomenon. Psychotic symptoms like delusions, hallucinations or catatonia/disorganized behavior can occur during episodes of Mania, Depression and Mixed States. If psychotic symptoms persist for two weeks or more after the resolution of mood symptoms, a diagnosis of Schizoaffective disorder is made.

Psychotic symptoms might be more common in those forms with an earlier age of onset.

The psychotic symptoms might be congruent with the mood state experienced (grandiose delusions in the course of euphoric mania) or non-congruent (delusions of guilt during mania).

In general, psychotic symptoms have been associated with a worse outcome in adults with MDI.