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J Affect Disord. 1996 Feb 12;37(1):23-9.

Mood-congruent versus mood-incongruent psychotic symptoms in first-admission patients with affective disorder.

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Department of Psychiatry and Behavioral Science, State University of New York at Stony Brook 11794-8790, USA.


The distribution of mood-congruent and mood-incongruent symptoms in 49 first-admission DSM-III-R psychotic bipolar and 35 psychotic depressed patients is presented. Most patients had mood-incongruent symptoms (77.4%). 73% of mood-incongruent bipolars and 32% of incongruent depressives had a combination of mood-congruent and mood-incongruent symptoms. Demographic and clinical variables were unrelated to incongruence. The only 24-month clinical outcome predicted by mood incongruence was poorer GAF rating. 15 of the 16 patients whose diagnosis was changed at follow-up from affective to nonaffective psychosis had mood-incongruent features initially. The findings raise questions about the general prognostic utility of mood congruence.

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