Polarity of the First Episode and Time to Diagnosis of Bipolar I Disorder

Objective The current study explored the relationship between the polarity of the first episode and the timing of eventual diagnosis of bipolar I disorder, and associated clinical implications. Methods Twelve years of clinical data from the medical records of 258 inpatients meeting DSM-III-R or DSM-IV criteria for bipolar I disorder were analyzed. Subjects were divided into two groups according to the polarity of the first episode: those with depressive polarity (FE-D), and those with manic polarity (FE-M). Comparisons were made between the two groups on variables associated with the timing of diagnosis and related outcomes. Results In Population with bipolar I disorder, a significant longer time lapse from the first major mood episode to the confirmed diagnosis was associated with the FE-D group compared to the FE-M group [5.6 (+/- 6.1) vs. 2.5 (+/- 5.5) years, p<0.001]. FE-D subjects tended to have prior diagnoses of schizophrenia and major depressive disorder while FE-M subjects tended to have prior diagnoses of bipolar disorder and schizophrenia. A significantly higher rate of suicide attempts was associated with the FE-D group compared to the FE-M group (12.7 vs. 1.7%, p<0.001). Conclusion The results of this study indicate that first-episode depressive polarity is likely to be followed by a considerable delay until an eventual confirmed diagnosis of bipolar I disorder. Given that first-episode depressive patients are particularly vulnerable to unfavorable clinical Outcomes Such as suicide attempts, a more systematic approach is needed to differentiate bipolar disorder among depressed patients in their early stages.Rosa AR, 2008, J AFFECT DISORDERS, V107, P45, DOI 10.1016/j.jad.2007.07.021Chaudhury SR, 2007, J AFFECT DISORDERS, V104, P245, DOI 10.1016/j.jad.2007.02.022Berk M, 2007, J AFFECT DISORDERS, V103, P181, DOI 10.1016/j.jad.2007.01.027Benazzi F, 2007, LANCET, V369, P935GOODWIN FK, 2007, MANIC DEPRESSIVE ILLDaban C, 2006, COMPR PSYCHIAT, V47, P433, DOI 10.1016/j.comppsych.2006.03.009McElroy SL, 2006, BIPOLAR DISORD, V8, P596Kassem L, 2006, AM J PSYCHIAT, V163, P1754Colom F, 2006, J AFFECT DISORDERS, V93, P13, DOI 10.1016/j.jad.2006.01.032Perlis RH, 2005, AM J MANAG CARE, V11, pS271Perlis RH, 2005, BIOL PSYCHIAT, V58, P549, DOI 10.1016/j.biopsych.2005.07.029Gazalle FK, 2005, J AFFECT DISORDERS, V86, P313, DOI 10.1016/j.jad.2005.01.003Ghaemi SN, 2005, J AFFECT DISORDERS, V84, P273, DOI 10.1016/S0165-0327(03)00196-4Post JC, 2005, CURR OPIN ALLERGY CL, V5, P5Mitchell PB, 2004, BIPOLAR DISORD, V6, P530Goodwin FK, 2003, JAMA-J AM MED ASSOC, V290, P1467Morselli PL, 2003, BIPOLAR DISORD, V5, P265Daniels BA, 2003, J AFFECT DISORDERS, V75, P163, DOI 10.1016/S0165-0327(02)00041-1Baethge C, 2003, ACTA PSYCHIAT SCAND, V107, P260Hirschfeld RMA, 2003, J CLIN PSYCHIAT, V64, P161Goldberg JF, 2002, J CLIN PSYCHIAT, V63, P985Ghaemi SN, 2002, CAN J PSYCHIAT, V47, P125Suppes T, 2001, J AFFECT DISORDERS, V67, P45Hirsch M, 2001, YALE J CRIT, V14, P5Bowden CL, 2001, PSYCHIATR SERV, V52, P51Hirschfeld RMA, 2000, AM J PSYCHIAT, V157, P1873Ghaemi SN, 2000, J CLIN PSYCHIAT, V61, P804Perugi G, 2000, COMPR PSYCHIAT, V41, P13GHAEMI SN, 2000, J CLIN PSYCHIAT, V61, P809Ghaemi SN, 1999, J AFFECT DISORDERS, V52, P135Baldessarini RJ, 1999, J CLIN PSYCHIAT, V60, P77BALDESSARINI RJ, 1999, J CLIN PSYCHIAT S2, V60, P111LISH JD, 1994, J AFFECT DISORDERS, V31, P281WEHR TA, 1988, AM J PSYCHIAT, V145, P179

Impact of Anxiety Disorder on Gray Matter Volume Changes in Patients with Bipolar II Disorder

Background: Comorbid anxiety disorders are frequently found in patients with bipolar disorder and may complicate the treatment of the disorder. Little is known about the interplay between bipolar disorder and anxiety disorder. The purpose of the current study was to investigate the effects of comorbid anxiety disorders on volumetric changes in brain of patients with bipolar II disorder.

Review of Cohort Studies for Mood Disorders

This paper aimed to review currently available cohort studies of subjects with mood disorders such as major depressive disorder (MDD) and bipolar disorder (BD). Using the PubMed and KoreaMed databases, we reviewed eight major cohort studies. Most studies recruited participants with MDD and BD separately, so direct comparison of factors associated with diagnostic changes was difficult. Regular and frequent follow-up evaluations utilizing objective mood ratings and standardized evaluation methods in a naturalistic fashion are necessary to determine detailed clinical courses of mood disorders. Further, biological samples should also be collected to incorporate clinical findings in the development of new diagnostic and therapeutic approaches. An innovative cohort study that can serve as a platform for translational research for treatment and prevention of mood disorders is critical in determining clinical, psychosocial, neurobiological and genetic factors associated with long-term courses and consequences of mood disorders in Korean patients