Bipolar psychosis can be a lot for anyone to deal with. It can also be challenging for the clinician to understand the experience of the client’s psychotic features. Is it schizophrenia? Is it bipolar? If bipolar, how often do people actually experience psychosis? And what does it look like?
Bipolar with psychotic features can look like more than stereotypical delusions like hearing the dead or speaking the voice of God. It can also include more plausible delusions and hallucinations.
In a study of bipolar I clients, nearly 70% experience delusions and over 40% experience hallucinations. Bipolar psychosis clients who experience delusions experience more grandiose and referential delusions. Clients with schizophrenia tend to experience more persecutory and body control delusions.
According to a systematic review, between half and two-thirds of people diagnosed with bipolar will experience a psychotic episode. However, a separate study found the number to be closer to 40%. This may be in part due to the differing countries in which the samples were obtained.
Results from multiple studies also suggest clients are more likely to experience a psychotic episode while in mania or when experiencing a mixed episode compared to a depressive episode.
Multiple diagnoses can include psychosis. However, the prevalence and types of delusions and hallucinations can vary between bipolar psychosis and other types of psychotic symptoms. Knowing what to look out for when a client is experiencing psychosis can help determine what to reality test and how best to support clients.
