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Meta-Analysis
. 2022 Oct;52(13):2413-2425.
doi: 10.1017/S003329172200201X. Epub 2022 Aug 26.

Lifetime and point prevalence of psychotic symptoms in adults with bipolar disorders: a systematic review and meta-analysis

S R Aminoff  1   2 , I N Onyeka  3 , M Ødegaard  4 , C Simonsen  1   2 , T V Lagerberg  1 , O A Andreassen  1 , K L Romm  2 , I Melle  1
Affiliations
Meta-Analysis

Lifetime and point prevalence of psychotic symptoms in adults with bipolar disorders: a systematic review and meta-analysis

S R Aminoff et al. Psychol Med. 2022 Oct.

Abstract

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 (N = 23 461) of adults with BD met the predefined inclusion criteria for evaluating lifetime prevalence, and 24 studies (N = 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 57.5-68) and 22% (95% CI 14-33) in BDII. For BDI inpatients, the pooled lifetime prevalence was 71% (95% CI 61-79). There were no studies of community samples or inpatient BDII. The pooled point prevalence of psychotic symptoms in BDI was 54% (95 CI 41-67). The point prevalence was 57% (95% CI 47-66) in manic episodes and 13% (95% CI 7-23.5) 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.Prospero registration number: CRD 42017052706.

Keywords: Adults; bipolar disorder; bipolar type I disorder; bipolar type II disorder; lifetime prevalence of psychotic symptoms; meta-analysis; point prevalence of psychotic symptoms; systematic review.

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Figures

Fig. 1.
Fig. 1.
PRISMA 2020 flow diagram for new systematic reviews which included searches of databases and registers only.
Fig. 2.
Fig. 2.
Forest plots of included studies of at least moderate quality in bipolar type I and type II disorder.
Fig. 3.
Fig. 3.
Forest plot of included studies of at least moderate quality in point prevalence of psychotic symptoms in bipolar type I disorder.
See this image and copyright information in PMC

References

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    1. Aminoff, S., Melle, I., Ødegaard, M., & Onyeka, I. (2017). The prevalence of psychotic symptoms in adults with bipolar disorder: a systematic review and meta-analysis. - PMC - PubMed

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