In the patients reported here, the psychosis was characterised by symptoms such as confusion, auditory hallucinations, and paranoid behaviour on the one hand and an increase in obsessive rituals, anxieties, and mood swings on the other, and was preceded by affective instability for many years. Although the actual psychopathology justifies a diagnosis of cycloid psychosis, longitudinal evaluation points towards an atypical bipolar disorder. It can therefore be hypothesised that the psychopathological phenotype of PWS patients with an UPD aetiology also comprises an increased risk for a bipolar affective disorder.
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