Clinical correlates of first-episode polarity in bipolar disorder.

Full Abstract

OBJECTIVE:
To determine the clinical and long-term implications of mood polarity at illness onset.

METHODS:
During a 10-year follow-up prospective study, systematic clinical and outcome data were collected from 300 bipolar I and II patients. The sample was split into 2 groups according to the polarity of the onset episode (depressive onset [DO] vs manic/hypomanic onset [MO]). Clinical features and social functioning were compared between the 2 groups of patients.

RESULTS:
In our sample, 67% of the patients experienced a depressive onset. Depressive onset patients were more chronic than MO patients, with a higher number of total episodes and a longer duration of illness. Depressive onset patients experienced a higher number of depressive episodes than MO patients, who in turn had more manic episodes. Depressive onset patients made more suicide attempts, had a later illness onset, were less often hospitalized, and were less likely to develop psychotic symptoms. Depressive onset was more prevalent among bipolar II patients. Bipolar I patients with DO had more axis II comorbidity and were more susceptible to have a history of psychotic symptoms than bipolar II patients with DO.

CONCLUSION:
The polarity at onset is a good predictor of the polarity of subsequent episodes over time. A depressive onset is twice as frequent as MO and carries more chronicity and cyclicity.

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Author information

Author/s: Daban, Claire (C); Colom, Francesc (F); Sanchez-Moreno, Jose (J); García-Amador, Margarita (M); Vieta, Eduard (E);

Affiliation: Clinical Institute of Neuroscience, Hospital Clinic, University of Barcelona, Villarroel 170, 08036 Barcelona, Spain.

Journal and publication information

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

Journal: Comprehensive psychiatry (Compr Psychiatry), published in United States. (Language: eng)

Reference: -2006 Nov-Dec; vol 47 (issue 6) : pp 433-7

Dates: Created 2006/10/27; Completed 2007/02/06; Revised 2007/11/15;

PMID: 17067865, 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.

Adolescent
Adult
Affect
Bipolar Disorder - diagnosis; epidemiology; psychology
Chronic Disease
Cross-Sectional Studies
Female
Follow-Up Studies
Hospitalization - statistics & numerical data

Humans
Male
Prognosis
Prospective Studies
Psychotic Disorders - diagnosis; epidemiology; psychology
Social Behavior
Spain
Statistics as Topic
Suicide, Attempted - psychology; statistics & numerical data

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