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My understanding is that the psychosis would definitely be within the context of a manic episode (though I understand you can have depressive episodes with psychosis as well), in which, along with the psychosis (delusions or however it manifests itself) you would also have to exhibit some of the other symptoms of mania (lack of sleep, etc.).
You probably know what psychosis is, its different flavors, Bipolar 1 *with* psychosis, is just one form of bipolar where (I would think usually manic episodes) are accompanied by psychosis. I suspect it doesn't mean, though, that you necessarily become psychotic with every episode.
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