Predominant polarity in bipolar disorder: diagnostic implications.

Full Abstract

BACKGROUND:
It has been reported that patients with bipolar disorder (BD) remain about 10 years symptomatic before the correct diagnosis is made. This fact is particularly important for patients with predominantly depressed polarity who tend to be diagnosed as suffering from unipolar major depressive disorder and treated with antidepressants. The present study was carried out to assess clinical differences between predominantly manic and depressed BD patients with a special focus on the time that patients remained undiagnosed.

METHODS:
Clinical and socio-demographic characteristics were obtained from a sample of 149 euthymic bipolar outpatients. Patients were divided into depressive or manic predominance of polarity. Clinical features, number of years undiagnosed (NYU) and occupational functioning were assessed in the two groups.

RESULTS:
Forty-five patients were classified as a "Depressive Polarity" whilst forty-seven were considered as "Manic Polarity". Depressive Polarity was associated with a longer delay to be diagnosed (F=14.43, df=89, p=0.001). The predominantly depressive patients tended to present a depressive onset of illness, earlier age of onset, longer duration of illness and higher number of suicide attempts than manic polarity patients.

CONCLUSION:
There was a marked clinical difference between predominantly manic and depressive bipolar patients. Predominantly depressive polarity is associated with a longer delay in receiving a correct diagnosis and effective treatment which has an important impact on the management of the illness.

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Author information

Author/s: Rosa, A R (AR); Andreazza, A C (AC); Kunz, M (M); Gomes, F (F); Santin, A (A); Sanchez-Moreno, J (J); Reinares, M (M); Colom, F (F); Vieta, E (E); Kapczinski, F (F);

Affiliation: Bipolar Disorders Program, Hospital Clinic of Porto Alegre, Ramiro Barcelos, 2350, 90035-003, Porto Alegre, RS, Brazil.

Journal and publication information

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

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

Reference: 2008-Apr; vol 107 (issue 1-3) : pp 45-51

Dates: Created 2008/03/03; Completed 2008/05/27;

PMID: 17804081, status: MEDLINE (last retrieval date: 11/6/2008)

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MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Adult
Age of Onset
Ambulatory Care
Bipolar Disorder - classification; diagnosis; psychology
Depressive Disorder - diagnosis; psychology
Depressive Disorder, Major - diagnosis; psychology
Diagnosis, Differential
Disease Management

Female
Humans
Male
Middle Aged
Occupations - statistics & numerical data
Suicide, Attempted - psychology; statistics & numerical data
Time Factors
Work Capacity Evaluation

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