Differences in outcome of DSM‐IV bipolar I and II disorders
- 8 April 2008
- journal article
- Published by Wiley in Bipolar Disorders
- Vol. 10 (3), 413-425
- https://doi.org/10.1111/j.1399-5618.2007.00502.x
Abstract
To investigate whether the course of bipolar disorder (BD) type II is more depressive than that of BD I, and, if so, to explore the underlying factors that cause this difference. In a prospective, naturalistic study of 191 secondary care psychiatric in- and outpatients diagnosed in an acute phase of BD I or II, 160 patients (85.1%) were followed for 18 months. Using a life chart, the exact timing of symptom states in follow-up was examined. Differences between BD I (n = 75) and II (n = 85) in duration of index phase and episode, time to full remission and recurrence, and time in any mood episode were investigated. Patients with BD II spent a higher proportion of time ill (47.5% versus 37.7%; p = 0.02) and in depressive symptom states (58.0% versus 41.7%; p = 0.003) than BD I patients. This was a result of the higher proportion (61.7% versus 48.6%; p = 0.03) and mean number (1.69 versus 1.11; p = 0.006) of depressive illness phases in BD II, rather than of differences in the duration of depressive phases. Type of index phase strongly predicted the outcome. In linear regression models, both BD II and type of index phase predicted more time spent in depressive symptom states. In medium-term follow-up, BD II patients spend about 40% more time in depressive symptom states than BD I patients because a higher proportion of BD II patients have depressive phases and the frequency of these is higher. Differences in type of index phase may markedly confound differences in outcome between BD I and II.Keywords
This publication has 40 references indexed in Scilit:
- Correlates of 1-Year Prospective Outcome in Bipolar Disorder: Results From the Stanley Foundation Bipolar NetworkAmerican Journal of Psychiatry, 2004
- The World Federation of Socleties of Biological Psychiatry (WFSBP) Guidelines for the Biological Treatment of Bipolar Disorders, Part II: Treatment of ManiaThe World Journal of Biological Psychiatry, 2003
- Response to Letter to the Editor from Sireling, World J Biol Psychiatry (2003) 4, 195: Comment on the WFSBP guidelines for the biological treatment of bipolar disorders, Part II: Treatment of maniaThe World Journal of Biological Psychiatry, 2003
- World Federation of Societies of Biological Psychiatry (WFSBP) Guidelines for Biological Treatment of Bipolar Disorders, Part I: Treatment of Bipolar DepressionThe World Journal of Biological Psychiatry, 2002
- Bipolar I affective disorder: predictors of outcome after 15 yearsJournal of Affective Disorders, 1998
- Bipolar II illness: course and outcome over a five-year periodPsychological Medicine, 1989
- A Rating Scale for Mania: Reliability, Validity and SensitivityThe British Journal of Psychiatry, 1978
- The measurement of pessimism: The Hopelessness Scale.Journal of Consulting and Clinical Psychology, 1974
- A RATING SCALE FOR DEPRESSIONJournal of Neurology, Neurosurgery & Psychiatry, 1960
- THE ASSESSMENT OF ANXIETY STATES BY RATINGPsychology and Psychotherapy: Theory, Research and Practice, 1959