Bipolar versus unipolar and primary versus secondary affective disorder: Which diagnosis takes precedence?

Nancy C Andreasen; William M Grove; William H Coryell; Jean Endicott; Paula J Clayton

doi:10.1016/0165-0327(88)90011-0

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Bipolar versus unipolar and primary versus secondary affective disorder: Which diagnosis takes precedence?

Journal article

Peer reviewed

Bipolar versus unipolar and primary versus secondary affective disorder: Which diagnosis takes precedence?

Nancy C Andreasen, William M Grove, William H Coryell, Jean Endicott and Paula J Clayton

Journal of affective disorders, Vol.15(1), pp.69-80

1988

DOI: 10.1016/0165-0327(88)90011-0

PMID: 2970495

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Abstract

The primary versus secondary distinction is often used as a way of subtyping depression. Its applicability to bipolar disorders has been unclear. This report examines the relative primacy of the bipolar versus unipolar distinction as compared to the primary versus secondary distinction in a sample of 955 patients in the NIMH Collaborative Study of the Psychobiology of Depression. These patients are divided into nine groups of the basis of whether they are bipolar I, bipolar II, or unipolar, and whether they are primary, ‘pure’ secondary, or ‘complicated’ secondary (i.e., bipolar I primary, bipolar I pure secondary, bipolar I complicated, etc.). Three sets of variables are used to determine the predictive validity of these various subtypes: data concerning age of onset and phenomenology of current episode, outcome, and familial prevalence. In general, data from these three sets of validators suggest that the bipolar distinction takes precedence over the primary versus secondary distinction. Within bipolars, there is little value in further subtyping into primary versus secondary.

Precedence

Primary-secondary

Unipolar-bipolar

Details

Title: Subtitle: Bipolar versus unipolar and primary versus secondary affective disorder: Which diagnosis takes precedence?
Creators: Nancy C Andreasen - Department of Psychiatry, University of Iowa College of Medicine, Iowa City, IA 52242, U.S.A
William M Grove - Department of Psychiatry, University of Minnesota School of Medicine, Minneapolis, MN 55455, U.S.A
William H Coryell - Department of Psychiatry, University of Iowa College of Medicine, Iowa City, IA 52242, U.S.A
Jean Endicott - New York State Psychiatric Institute, New York, NY 10032, U.S.A
Paula J Clayton - Department of Psychiatry, University of Minnesota School of Medicine, Minneapolis, MN 55455, U.S.A
Resource Type: Journal article
Publication Details: Journal of affective disorders, Vol.15(1), pp.69-80
DOI: 10.1016/0165-0327(88)90011-0
PMID: 2970495
NLM abbreviation: J Affect Disord
ISSN: 0165-0327
eISSN: 1573-2517
Publisher: Elsevier B.V
Language: English
Date published: 1988
Academic Unit: Psychiatry; Iowa Neuroscience Institute
Record Identifier: 9984003418402771

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