Match!

Longitudinal course of bipolar I disorder

Published on Nov 1, 2004in Comprehensive Psychiatry2.586
· DOI :10.1016/j.comppsych.2004.07.005
Ivan W. Miller65
Estimated H-index: 65
(Rhode Island Hospital),
Lisa A. Uebelacker26
Estimated H-index: 26
(Rhode Island Hospital)
+ 2 AuthorsDavid A. Solomon12
Estimated H-index: 12
(Rhode Island Hospital)
Abstract
The course of bipolar I disorder is characterized by frequently fluctuating levels of manic and depressive symptoms. In the current study, we sought to characterize the month-by- month course of this disorder in 61 patients who were originally enrolled in a clinical trial and were followed for a mean of 23.7 months (SD = 6.1). All patients in the trial received medication management; some received family psychosocial interventions as well. On a monthly basis, we assessed symptom severity using the Modified Hamilton Rating Scale for Depression (MHRSD) and the Bech-Rafaelson Mania Scale (BRMS). Each month, we categorized each participant as fully symptomatic, partially symptomatic, or asymptomatic in terms of both depressed and manic symptoms. We found that the median percent time fully symptomatic was 8%, the median percent time partially symptomatic was 22%, and the median percent time asymptomatic was 59%. Using DSM-IV-TR criteria for defining an acute mood episode, we found that the median length of episode was 1 month, and participants experienced, on average, one episode every 8 months. Estimates concerning percent time fully symptomatic and asymptomatic converge with those reported in other datasets.
  • References (56)
  • Citations (26)
📖 Papers frequently viewed together
1,443 Citations
334 Citations
460 Citations
78% of Scinapse members use related papers. After signing in, all features are FREE.
References56
Newest
#1Lars Vedel KessingH-Index: 57
#2Mette Gerster Hansen (UCPH: University of Copenhagen)H-Index: 4
Last. Per Kragh Andersen (UCPH: University of Copenhagen)H-Index: 79
view all 3 authors...
Background Newer antidepressants have increasingly been used during the past decade. These drugs may increase compliance and reduce the risk of cycle acceleration in affective disorders. Aims To investigate the naturalistic longitudinal course of illness in patients with depressive or bipolar disorder following the use of recently introduced drugs. Method The rates of relapse leading to hospitalisation after successive episodes were calculated in a case register study including all hospital admi...
125 CitationsSource
#1Willem A. NolenH-Index: 83
Last. Robert M. PostH-Index: 118
view all 10 authors...
OBJECTIVE: The purpose of the study was to examine potential correlates of outcome in patients treated for bipolar disorder. METHOD: During a 1-year period, 258 patients with DSM-IV bipolar disorder or schizoaffective disorder were rated with the prospective NIMH-Life Chart Method, which characterizes each day in terms of the severity of manic and depressive symptoms on the basis of patients’ mood-related impairment in their usual educational, social, or occupational roles. Mean ratings for the ...
113 CitationsSource
#1Ivan W. Miller (Brown University)H-Index: 65
#2David A. Solomon (Brown University)H-Index: 45
Last. Gabor I. Keitner (Brown University)H-Index: 47
view all 4 authors...
72 CitationsSource
#1Jules Angst (UZH: University of Zurich)H-Index: 82
#2Alex Gamma (UZH: University of Zurich)H-Index: 48
Last. Heping Zhang (Yale University)H-Index: 56
view all 5 authors...
Objective: It is not known whether the risk of recurrence declines with time in bipolar disorders and in major depression. This study describes the life-long recurrence risk of bipolar I, bipolar II and major depressive disorders.
124 CitationsSource
#1William CoryellH-Index: 90
#2David A. SolomonH-Index: 45
Last. Timothy I. MuellerH-Index: 38
view all 9 authors...
Background: Rapid cycling among patients with bipolar affective disorders is important because of its implications for long-term prognosis and for the use of antidepressants. To our knowledge, no prospective study has, as yet, described the course of this phenomenon beyond 5 years. Methods: From 345 patients with bipolar I or bipolar II disorder followed up for a mean (SD) of 13.7 (6.1) years as part of the National Institute of Mental Health Collaborative Depression Study, 89 (25.8%) were ident...
181 CitationsSource
#1Robert M. Post (NIH: National Institutes of Health)H-Index: 118
#2Kirk D. Denicoff (NIH: National Institutes of Health)H-Index: 35
Last. Willem A. NolenH-Index: 83
view all 13 authors...
Background. A number of recent longitudinal outcome studies have found substantial long-term morbidity in patients with bipolar disorder. The detailed course and pattern of illness emerging despite comprehensive treatment with mood stabilizers and adjunctive agents have previously not been well delineated. Method: 258 consecutive outpatients admitted from 1996 to 1999 to the Stanley Foundation Bipolar Network who had a full year of prospective daily clinician ratings on the National Institute of...
341 CitationsSource
#1Gary S. Sachs (Harvard University)H-Index: 80
#2Michael E. Thase (University of Pittsburgh)H-Index: 116
Last. Jerrold F. Rosenbaum (Harvard University)H-Index: 87
view all 18 authors...
Abstract The Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD) was conceived in response to a National Institute of Mental Health initiative seeking a public health intervention model that could generate externally valid answers to treatment effectiveness questions related to bipolar disorder. STEP-BD, like all effectiveness research, faces many design challenges, including how to do the following: recruit a representative sample of patients for studies of readily available...
393 CitationsSource
#1Lewis L. Judd (UCSD: University of California, San Diego)H-Index: 53
#2Hagop S. Akiskal (UCSD: University of California, San Diego)H-Index: 108
Background: Despite emerging international consensus on the high prevalence of the bipolar spectrum in both clinical and community samples, many skeptics contend that narrowly defined bipolar disorder with a lifetime rate of about 1% represents a more accurate estimate of prevalence. This may in part be due to the fact that higher figures proposed for the bipolar spectrum (5–8%) have not been based on national data and have not included all levels of manic symptom severity. In the present second...
602 CitationsSource
#1Jules Angst (UZH: University of Zurich)H-Index: 82
#2Alex Gamma (UZH: University of Zurich)H-Index: 48
Last. Wulf Rössler (UZH: University of Zurich)H-Index: 61
view all 6 authors...
Abstract Background: The boundaries of bipolarity have been expanding over the past decade. Using a well characterized epidemiologic cohort, in this paper our objectives were: (1) to test the diagnostic criteria of DSM-IV hypomania, (2) to develop and validate criteria for the definition of softer expressions of bipolar-II (BP-II) disorder and hypomania, (3) to demonstrate the prevalence, clinical validity and comorbidity of the entire soft bipolar spectrum. Methods : Data on the continuum from ...
637 CitationsSource
#1Mario MajH-Index: 63
#2Raffaele PirozziH-Index: 10
Last. Luca BartoliH-Index: 11
view all 4 authors...
OBJECTIVE: This study explored whether “switching” (i.e., the direct transition from one mood polarity to the other) has significant prognostic implications in patients with bipolar disorder. METHOD: Bipolar disorder patients (N=97) whose first prospectively observed episode included at least one mood polarity switch and 97 bipolar disorder patients whose index episode was monophasic were compared with respect to several demographic and historical variables, symptomatic features of the index epi...
43 CitationsSource
Cited By26
Newest
Resumen El trastorno bipolar (TB) es una enfermedad mental grave, de caracter cronico y altamente incapacitante. La clinica principal se basa en severos cambios del animo que tienen una duracion de semanas a meses. Las descompensaciones agudas de la enfermedad requieren con frecuencia una hospitalizacion, debido a la presencia de sintomas psicoticos, el alto riesgo de conductas suicidas, o las alteraciones de conductas de los pacientes. Los episodios maniacos o hipomaniacos son los que determina...
Source
#1Susan J. Wenze (Brown University)H-Index: 14
#2Brandon A. Gaudiano (Brown University)H-Index: 30
Last. Ivan W. Miller (Brown University)H-Index: 65
view all 5 authors...
Abstract Bipolar disorder and substance use disorders are highly debilitating conditions, and especially when co-occurring, are associated with a variety of negative outcomes. Surprisingly, there is a relative lack of research on feasible and effective psychosocial treatments for individuals with comorbid bipolar and substance use disorder (BD-SUD), and a dearth of literature examining interventions designed specifically to improve outcomes such as symptoms, functioning, and treatment engagement...
13 CitationsSource
#1Eran Eldar (Princeton University)H-Index: 10
#2Yael Niv (Princeton University)H-Index: 43
Whether emotional state affects the perception of outcomes, and the possible consequences of this interaction remain unclear. Here the authors use behavioural tests and brain imaging to study the bidirectional interaction between emotional state and learning in humans and find that this interaction may play a role in mood instability.
39 CitationsSource
#1Julian D. Ford (University of Connecticut Health Center)H-Index: 55
#2Damion J. GrassoH-Index: 17
Last. Christine A. CourtoisH-Index: 19
view all 4 authors...
Exposure to traumatic stressors can happen at any time in a person’s life. Although some age groups are more susceptible to exposure to certain types of traumatic stressors (e.g., young adults are more likely to encounter war-related traumatic stressors than younger or older people because that is the developmental period in which military service most often occurs), all traumatic stressors can occur at any point in the life span. Therefore, with each passing year of life, the probability of hav...
Source
#1Fernanda Novis (UFRJ: Federal University of Rio de Janeiro)H-Index: 5
#2Patricia Cirillo (UFRJ: Federal University of Rio de Janeiro)H-Index: 2
Last. Elie Cheniaux (UERJ: Rio de Janeiro State University)H-Index: 12
view all 9 authors...
INTRODUCAO: Estudos prospectivos vem demonstrando que o curso do transtorno bipolar (TB) e marcado por uma persistencia de sintomas em grande parte do tempo, sendo estes predominantemente depressivos. Porem, ate onde sabemos, nao ha estudos na America Latina sobre o assunto. OBJETIVO: Replicar pesquisas internacionais com uma amostra brasileira, para estudar prospectivamente a evolucao no primeiro ano de tratamento e possiveis fatores relacionados a cronicidade. METODO: Acompanhamos 102 paciente...
1 CitationsSource
#1Angela NicholasH-Index: 9
#1A NicholasH-Index: 1
Last. S PollockH-Index: 1
view all 4 authors...
2 Citations
#1Fernanda NovisH-Index: 5
#2Patricia CirilloH-Index: 2
Last. Elie CheniauxH-Index: 12
view all 9 authors...
Introduction: Prospective studies have shown that the course of bipolar disorder (BD) is characterized by the persistence of symptoms, predominantly depression, along most of the time. However, to our knowledge, no studies in Latin America have investigated it. Objectives: To replicate international studies using a Brazilian sample to prospectively analyze treatment outcomes in the first year and to determine potential chronicity factors. Methods: We followed up 102 patients with BD for 12 month...
Resume L’importance de la pathologie intercritique dans le trouble bipolaire remonte a la moitie du xix e siecle, periode durant laquelle, les deux peres du concept en France, Falret et Baillarger, etaient opposes sur la question de savoir si la presence d’intervalles libres entre les episodes devait ou non faire partie de la definition de la maladie. Les etudes modernes ont rapporte des taux de prevalence entre 50 et 68% pour ces symptomes qui font reference a des manifestations subsyndromales ...
2 CitationsSource
#1John E. Zeber (University of Texas Health Science Center at San Antonio)H-Index: 31
#2Alexander L. Miller (University of Texas Health Science Center at San Antonio)H-Index: 47
Last. Amy M. Kilbourne (UM: University of Michigan)H-Index: 44
view all 8 authors...
Medication adherence is critical for patients with bipolar disorder to avoid symptom exacerbation and diminished quality of life. Most analyses consider adherence barriers individually rather than conjointly, while neglecting potential ethnic differences. 435 patients in the Continuous Improvement for Veterans in Care––Mood Disorders study reported multiple financial and psychosocial factors influencing adherence. Logistic regression modeled adherence as a function of perceived barriers, includi...
20 CitationsSource
#1Brandon A. Gaudiano (Brown University)H-Index: 30
#2Lauren M. WeinstockH-Index: 17
Last. Ivan W. MillerH-Index: 65
view all 3 authors...
Patients with comorbid bipolar and substance use disorders are at particularly high risk for treatment nonadherence and a host of negative consequences. However, no previous interventions have been designed specifically to address this problem. In the current study, we describe the rationale for and initial development of an adjunctive, psychosocial intervention that targets adherence in patients with bipolar disorder who are substance abusers. The intervention involves brief in-person sessions ...
19 CitationsSource