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- Title
American tertiary clinic-referred bipolar II disorder versus bipolar I disorder associated with hastened depressive recurrence.
- Authors
Dell'Osso, Bernardo; Shah, Saloni; Do, Dennis; Yuen, Laura; Hooshmand, Farnaz; Wang, Po; Miller, Shefali; Ketter, Terence
- Abstract
Background: Bipolar disorder (BD) is a chronic, frequently comorbid condition characterized by high rates of mood episode recurrence and suicidality. Little is known about prospective longitudinal characterization of BD type II (BD II) versus type I (BD I) in relation to time to depressive recurrence and recovery from major depressive episode. We therefore assessed times to depressive recurrence/recovery in tertiary clinic-referred BD II versus I patients. Methods: Outpatients referred to Stanford BD Clinic during 2000-2011 were assessed with Systematic Treatment Enhancement Program for BD (STEP-BD) Affective Disorders Evaluation and with Clinical Monitoring Form during up to 2 years of naturalistic treatment. Prevalence and clinical correlates of bipolar subtype in recovered (euthymic ≥8 weeks) and depressed patients were assessed. Kaplan-Meier analyses assessed the relationships between bipolar subtype and longitudinal depressive severity, and Cox proportional hazard analyses assessed the potential mediators. Results: BD II versus BD I was less common among 105 recovered (39.0 vs. 61.0%, p = 0.03) and more common among 153 depressed (61.4 vs. 38.6%, p = 0.006) patients. Among recovered patients, BD II was associated with 6/25 (24.0%) baseline unfavorable illness characteristics/mood symptoms/psychotropics and hastened depressive recurrence ( p = 0.015). Among depressed patients, BD II was associated with 8/25 (33.0%) baseline unfavorable illness characteristics/mood symptoms/psychotropics, but only non-significantly associated with delayed depressive recovery. Conclusions: BD II versus BD I was significantly associated with current depression and hastened depressive recurrence, but only non-significantly associated with delayed depressive recovery. Research on bipolar subtype relationships with depressive recurrence/recovery is warranted to enhance clinical management of BD patients.
- Subjects
BIPOLAR disorder; DISEASE relapse; MENTAL depression; KAPLAN-Meier estimator; SEVERITY of illness index
- Publication
International Journal of Bipolar Disorders, 2017, Vol 5, Issue 1, p1
- ISSN
2194-7511
- Publication type
Article
- DOI
10.1186/s40345-017-0072-x