Journal article
Course of illness following prospectively observed mania or hypomania in individuals presenting with unipolar depression
Bipolar disorders, Vol.14(6), pp.664-671
09/2012
DOI: 10.1111/j.1399-5618.2012.01041.x
PMCID: PMC3432672
PMID: 22816725
Abstract
Objectives: In a well-defined sample, we sought to determine which clinical variables, some of potential nosological relevance, influence subsequent course following prospectively observed initial episodes of hypomania or mania (H/M).
Methods: We identified 108 individuals in the National Institute of Mental Health Collaborative Depression Study diagnosed with unipolar major depression at intake who subsequently developed H/M. We assessed time to repeat H/M based on whether one had been started on an antidepressant or electroconvulsive therapy within eight weeks of developing H/M, had longer episodes, or had a family history of bipolar disorder.
Results: Modeling age of onset, treatment-associated H/M, family history of bipolar disorder, duration of index H/M episode, and psychosis in Cox regression analysis, family history of bipolar disorder (n=21) was strongly associated with repeat episodes of H/M [hazard ratio (HR)=2.01, 95% confidence interval (CI): 1.06-3.83, p=0.03]. Those with treatment-associated episodes (n=12) were less likely to experience subsequent episodes of H/M, although this was not significant in the multivariate model (HR=0.25, 95% CI: 0.06-1.05, p=0.06). These individuals also had a later age of onset for affective illness and were more likely to be depressed. Duration of illness with a temporal resolution of one week, psychosis, and age of onset were not associated with time to repeat H/M episode.
Conclusions: A family history of bipolar disorder influences the course of illness, even after an initial H/M episode. In this select sample, treatment-associated H/M did not appear to convey the same risk for a course of illness characterized by recurrent H/M episodes.
Details
- Title: Subtitle
- Course of illness following prospectively observed mania or hypomania in individuals presenting with unipolar depression
- Creators
- Jess G Fiedorowicz - Department of Psychiatry and Human Behavior, The Warren Alpert Medical School of Brown University Providence, RI, USAJean Endicott - Department of Psychiatry and Human Behavior, The Warren Alpert Medical School of Brown University Providence, RI, USADavid A Solomon - Department of Psychiatry and Human Behavior, The Warren Alpert Medical School of Brown University Providence, RI, USAMartin B Keller - Department of Psychiatry and Human Behavior, The Warren Alpert Medical School of Brown University Providence, RI, USAWilliam H Coryell - Department of Psychiatry and Human Behavior, The Warren Alpert Medical School of Brown University Providence, RI, USA
- Resource Type
- Journal article
- Publication Details
- Bipolar disorders, Vol.14(6), pp.664-671
- DOI
- 10.1111/j.1399-5618.2012.01041.x
- PMID
- 22816725
- PMCID
- PMC3432672
- NLM abbreviation
- Bipolar Disord
- ISSN
- 1398-5647
- eISSN
- 1399-5618
- Grant note
- K23 MH083695 || MH / National Institute of Mental Health : NIMH
- Language
- English
- Date published
- 09/2012
- Academic Unit
- Psychiatry; Epidemiology; Internal Medicine
- Record Identifier
- 9984003927502771
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