Bipolar II illness: course and outcome over a five-year period | Psychological Medicine | Cambridge Core (original) (raw)

Synopsis

A five year semi-annual follow-up of patients with non-bipolar (N = 442), bipolar II (N = 64) and bipolar I (N = 53) major depression tracked the courses of prospectively observed major depressive, hypomanic and manic syndromes. In all three groups, depression was much more likely in any given week than was hypomania or mania. However, during the majority of weeks, no full syndrome was present and none of the groups exhibited evidence of continuing psychosocial deterioration. Though all three groups exhibited similar times to recovery from index and subsequent major depressive episodes, both bipolar groups had substantially higher relapse rates and developed more episodes of major depression, hypomania and mania. The two bipolar groups, in turn, differed by the severity of manic-like syndromes and thus remained diagnostically stable; the bipolar II patients were much less likely to develop full manic syndromes or to be hospitalized during follow-up. In conjunction with family study data showing that bipolar II disorder breeds true, these data support the separation of bipolar I and bipolar II affective disorder.

References

Andreasen, N. C., Grove, W. M., Endicott, J., Coryell, W. H., Scheftner, W. A., Hirschfeld, R. M. A. & Keller, M. B. (1988) The phenomenology of depression. Psychiatrv and Psychobtology 3, 1–10.CrossRefGoogle Scholar

Angst, J. (1986). The course of major depression, atypical bipolar disorder, and bipolar disorder. In New Results in Depression Research (ed. Hippius, H.), pp. 26–35. Springer-Verlag: Berlin.CrossRefGoogle Scholar

Ayuso-Gutierrez, J. L. & Ramos-Brieda, J. A. (1982). The course of manic depressive illness. Journal of Affective Disorders 4, 9–14.CrossRefGoogle ScholarPubMed

Coryell, W. & Winokur, G. (1982). Course and outcome. In Handbook of Affective Disorders, (ed. Paykel, E. S.), pp. 93–106. Churchill Livingston: London.Google Scholar

Coryell, W., Endicott, J., Reich, T., Andreasen, N. & Keller, M. (1984 a). A family study of bipolar II disorder. British Journal of Psychiatry 145, 49–54CrossRefGoogle ScholarPubMed

Coryell, W., Lavori, P., Endicott, J., Keller, M. & VanEerdewegh, M. (1984 b). Outcome in schizo-affective, psychotic and nonpsychotic depression. Archives of General Psychiatry 41, 787–791.CrossRefGoogle Scholar

Coryell, W., Andreasen, N., Endicott, J. & Keller, M. (1987). The significance of past mania or hypomania in the course and outcome of major depression. American Journal of Psychiatry 144, 309–315.Google ScholarPubMed

Endicott, J & Spitzer, R. L. (1978). A diagnostic interview: the Schedule for Affective Disorders and Schizophrenia. Archives of General Psychiatry 35, 837–844.CrossRefGoogle ScholarPubMed

Endicott, J., Spitzer, R. J., Fleiss, J. L. & Cohen, J. (1976). The Global Assessment Scale: a procedure for measuring overall severity of psychiatric disturbance. Archives of General Psychiatry 33, 766–771.CrossRefGoogle Scholar

Endicott, J., Nee, JAndreasen, N., Clayton, P., Keller, M. & Coryell, W. (1985). Bipolar II: combine or keep separate? Journal of Affective Disorders 8, 17–28.CrossRefGoogle ScholarPubMed

Kalbfleisch, J. D. & Prentice, R. L. (1980). The Statistical Analysis of Failure Time Data, pp. 12–15. Wiley and Sons: New York.Google Scholar

Keller, M. B., Lavori, P. W., Endicott, J., Coryell, W. & Klerman, G. (1983). Double depression: two year follow-up. American Journal of Psychiatry 140, 689–694.Google ScholarPubMed

Keller, M. B., Lavori, P. W., Coryell, W., Andreasen, N., Endicott, J., Clayton, P., Klerman, G. & Hirschfeld, R. M. A. (1986). Differential outcome of pure manic, mixed/cycling, and pure depressive episodes in patients with bipolar illness. Journal of the American Medical Association 255, 3138–3142.CrossRefGoogle ScholarPubMed

Keller, M. B., Lavori, P. W., Friedman, B., Neilsen, E., Endicott, J., McDonald-Scott, P. & Andreasen, N. (1987). The longitudinal interval follow-up evaluation. Archives of General Psychiatry 44, 540–548.CrossRefGoogle ScholarPubMed

Kukopulos, A., Reginaldi, D., Laddomada, P., Floris, G., Serra, G., & Tondo, L. (1980). Course of the manic depressive cycle and changes caused by treatments. Pharmakopsychiatrie Neuro-psychopharmakologie 13, 156–167.CrossRefGoogle Scholar

MacDonald, M J. (1974). Equal incidence of adult-onset diabetes among ancestors of juvenile diabetics and nondiabetics. Diabetologia 10, 767–773.CrossRefGoogle Scholar

Spitzer, R. L., Endicott, J. & Robins, E. (1978). Research Diagnostic Criteria (third edn). Biometrics Research, New York State Department of Mental Hygeine: New York, NY.CrossRefGoogle ScholarPubMed

Welner, A., Welner, Z. & Leonard, M. A. (1977). Bipolar manic depressive disorder: a re-assessment of course and outcome. Comprehensive Psychiatry 18, 327–332.CrossRefGoogle Scholar

Winer, B. J. (1971). Statistical Principles in Experimental Design (second edn), p. 198. McGraw-Hill: New York.Google Scholar