Clinical and therapeutic implications of predominant polarity in bipolar disorder.

Full Abstract

BACKGROUND:
To determine the clinical and therapeutic relevance of longitudinally predominant polarity for bipolar disorders long-term outcome.

METHOD:
Two hundred twenty-four patients (n=224) were enrolled for the study in the Bipolar Disorders Program of Barcelona, which provides integrated care for difficult-to-treat bipolar patients derived from all over Spain, but also provides clinical care to all bipolar patients coming from a specific catchment area (Eixample Esquerre) in Barcelona. Data collection regarding predominant polarity started on October 1994 and lasted for the following ten years. Patients were divided according to the predominance of depressive or manic/hypomanic episodes. The two groups were compared regarding clinical and sociodemographic variables.

RESULTS:
135 patients (60.3%) were classified as Depressive Polarity, whilst 89 (39.7%) were considered as Manic Polarity. Manic Polarity was more prevalent amongst bipolar I patients than bipolar II. Depressive Polarity was strongly associated with depressive onset of bipolar disorder. Lifetime history of attempted suicide was strongly associated with Depressive Polarity, who also had a higher mean number of suicide attempts. As for therapeutic issues, acute and maintenance use of atypical antipsychotics and conventional neuroleptics were more common amongst Manic Polarity whilst antidepressants and lamotrigine use was highly prevalent amongst Depressive Polarity.

CONCLUSIONS:
Prevention of depression is crucial for the maintenance treatment of bipolar II patients, whilst prevention of mania and depression would be equally important in the case of bipolar I patients. Predominant polarity is a valid prognostic parameter with therapeutic implications.

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Author information

Author/s: Colom, F (F); Vieta, E (E); Daban, C (C); Pacchiarotti, I (I); Sánchez-Moreno, J (J);

Affiliation: Bipolar Disorders Program, Institut d'Investigacions Biomédiques Agustí Pi Sunyer, Barcelona Stanley Foundation Center, Spain.

Journal and publication information

Publication Type: Journal Article; Research Support, Non-U.S. Gov't

Journal: Journal of affective disorders (J Affect Disord), published in Netherlands. (Language: eng)

Reference: 2006-Jul; vol 93 (issue 1-3) : pp 13-7

Dates: Created 2006/06/07; Completed 2006/11/09; Revised 2006/11/15;

PMID: 16650901, status: MEDLINE (last retrieval date: 12/26/2008)

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MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Adult
Antidepressive Agents - therapeutic use
Antimanic Agents - therapeutic use
Antipsychotic Agents - therapeutic use
Bipolar Disorder - classification; diagnosis; drug therapy; epidemiology
Cross-Sectional Studies
Diagnostic and Statistical Manual of Mental Disorders
Drug Therapy, Combination
Female
Follow-Up Studies
Humans
Incidence

Incidence
Male
Middle Aged
Prognosis
Prospective Studies
Recurrence
Risk Factors
Socioeconomic Factors
Spain
Suicide, Attempted - prevention & control; psychology; statistics & numerical data
Treatment Outcome
Triazines - therapeutic use

Associated Chemicals: Antidepressive Agents (0) ; Antimanic Agents (0) ; Antipsychotic Agents (0) ; Triazines (0) ; lamotrigine (84057-84-1)

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