Citation

Cha B, Jeong HK, Tae HH, Jae SC, Ha K. Psychiatry Investig. 2009; 6(2): 96-101.

Copyright

(Copyright © 2009, Korean Neuropsychiatric Association)

DOI

10.4306/pi.2009.6.2.96

PMID

unavailable

Abstract

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. Copyright © 2009 Official Journal of Korean Neuropsychiatric Association.

Language: en

Keywords

adult; human; Suicide; female; male; Bipolar disorder; depression; schizophrenia; suicide attempt; major depression; mood; Diagnosis; mood disorder; article; comparative study; major clinical study; controlled study; medical record; diagnostic accuracy; mania; bipolar I disorder; diagnostic procedure; disease duration; diagnostic and statistical manual of mental disorders; outcome assessment; Polarity; First episode