Prevalence of psychotic symptoms and their impact on course and outcome of patients with bipolar disorder: Findings from the Bipolar Disorder Course and Outcome study from India (BiD-CoIN study).

AIM: Most of the available data on the prevalence and impact of psychotic symptoms on the course of bipolar disorder (BD) is from Western countries. We aimed to study the prevalence of at least one psychotic episode in the lifetime in patients with BD and its association with the long-term course and outcome. METHODOLOGY: 773 patients recruited as part of the Bipolar Disorder Course and Outcome study from India (BiD-CoIN study) were divided into 2 groups, based on the presence or absence of at least one psychotic episode in the lifetime. RESULTS: 326 (42.2%) patients had at least one psychotic episode in their lifetime. At least one psychotic episode in the lifetime was associated with overall more severe illness in terms of lower age of onset, a higher number of episodes in the first 5 years of illness; higher rates of BD-II, a higher rate of lifetime history of at least 1 suicide attempt, lifetime history of hospitalization, history of receiving Electroconvulsive Therapy, and a higher prescription rates of antipsychotics. However, presence of psychotics symptoms was associated with better cognitive functioning. CONCLUSIONS: Our findings suggest that the presence of psychotic symptoms during episodes in patients with BD is associated with poorer course of BD.

Designing and Conducting Knowledge, Attitude, and Practice Surveys in Psychiatry: Practical Guidance.

Knowledge, attitude, and practice (KAP) surveys are popular in health care because they provide useful information and appear easy to design and execute. There are subtleties, however, in such surveys that early career researchers need to be aware of. This article does not provide a detailed review of the subject, nor does it address theory; rather, it provides practical guidance on matters such as identifying the need for the survey; defining the target population; preparing the questions that address knowledge, attitudes, and practice; preparing options for the answers to the items in the questionnaire; deciding how to score the instrument and analyze the results; and validating the instrument. Specific examples are presented to help readers understand and apply the guidance in various contexts.