PSYCHOSENSORY SYMPTOMS IN BIPOLAR DISORDER

This study investigated psychosensory symptoms and their relationship to retrospective and prospective courses of illness, as well as therap eutic outcomes, in patients with bipolar disorder. Using the Silberman -Post Psychosensory Rating Scale (SP-PSRS), psychosensory symptoms wer e assessed in 51 patients who met Diagnostic and Statistical Manual, 3 rd Edition-Revised (DSM-III-R) criteria for bipolar disorder and in 39 healthy, normal controls. Patients with bipolar disorder were enrolle d in a 3-year, double-blind, randomized study comparing the prophylact ic efficacy of lithium or carbamazepine in the first year, a crossover to the other drug in the second year, and the combination of both med ications in the third year. Psychosensory scores from patients with bi polar disorder were compared with scores from healthy controls and wit h a variety of retrospective and prospective course of illness and tre atment variables. Psychosensory symptoms occurred frequently in patien ts with bipolar I and II disorders, but were rare in healthy controls. When depressed, patients with bipolar II disorder (n = 23) reported m ore psychosensory symptoms when compared to patients with bipolar I di sorder (n = 28), and those with a history of rapid cycling (n = 29) re ported more psychosensory symptoms when compared to patients without a history of rapid cycling (n = 21). Psychosensory symptoms were not re lated to response to carbamazepine, lithium, or the combination of bot h drugs. Although the presence of psychosensory symptoms is associated with some bipolar subtypes (patients with bipolar II disorder and pat ients with a history of rapid cycling), they do not appear to predict treatment response. Further studies are needed to assess the pathophys iologic implications of the presence of psychosensory symptoms and the ir potential implications, if any, for directing therapeutics.