Abstract： Objective： To explore the Five Circuits and Six Qi characteristics of the symptomatic phases in patients with bipolar disorder （BD），aiming to identify new entry points for understanding the underlying pathogenesis of BD. Methods：A total of 2 155 BD inpatients treated at Xiamen Xianyue Hospital from 1990 to 2020 were selected. Based on the symptomatic phases at onset， patients were divided into manic phase and depressive phase groups. According to the presence or absence of psychotic symptoms during the onset period，the manic phase group was further subdivided into a group with psychotic symptoms （n=859） and a group without psychotic symptoms （n=920）. Similarly， the depressive phase group was subdivided into a group with psychotic symptoms （n=92） and a group without psychotic symptoms （n=220）. The onset dates of BD patients were converted into Five Circuits and Six Qi data， and statistical analysis was performed on the distribution of these parameters. Results：In the manic phase，the distribution of guest qi showed a significant difference between the group with psychotic symptoms and the group without psychotic symptoms （P＜0.05）. However， no significant differences were observed in the distributions of annual circuit， host circuit，guest circuit，or host qi between the two groups （P＞0.05）. In the depressive phase，the distribution of host circuit showed a significant difference between the group with psychotic symptoms and the group without psychotic symptoms （P＜0.05）. However， no significant differences were observed in the distributions of annual circuit， guest circuit，host qi，or guest qi between the two groups （P＞0.05）. Conclusion：Psychotic symptoms in the manic phase of BD may be associated with guest qi of Reverting Yin Wind-Wood. Manic phases without psychotic symptoms may be related to guest qi of Lesser Yin Sovereign Fire. Psychotic symptoms in the depressive phase of BD may be associated with the excessive host circuit of Greater Wood. Depressive phases without psychotic symptoms may be related to the host circuits of Lesser Earth and Greater Fire. From the perspective of Five Circuits and Six Qi，the emergence of psychotic symptoms in BD patients may be a severe condition where Reverting Yin Wind-Wood or excessive Wood circuit stirs liver wind，combined with excess-pathogens，leading to deactivation of the vital activity.