Citation

García-Jiménez J, Álvarez-Fernández M, Aguado-Bailón L, Gutiérrez-Rojas L. Revista de Psiquiatría y Salud Mental (English Edition) 2019; 12(1): 52-62.

Copyright

(Copyright © 2019, Elsevier Publishing)

DOI

10.1016/j.rpsm.2017.06.008

PMID

28818612

Abstract

INTRODUCTION: Current classification of bipolar disorder (BD) in type i or type ii, however useful, may be insufficient to provide relevant clinical information in some patients. As a result, complementary classifications are being proposed, like the predominant polarity (PP) based, which is defined as a clear tendency in the patient to present relapses in the manic or depressive poles.
METHODS: We carried out a search in PubMed and Web of Science databases, following the Preferred Items for Reporting of Systematic Reviews and Meta-Analyses -PRISMA- guidelines, to identify studies about BD reporting PP. The search is updated to June 2016.
RESULTS: Initial search revealed 907 articles, of which 16 met inclusion criteria. Manic PP was found to be associated with manic onset, drug consumption prior to onset and a better response to atypical antipsychotics and mood stabilisers. Depressive PP showed an association with depressive onset, more relapses, prolonged acute episodes, a greater suicide risk and a later diagnosis of BD. Depressive PP was also associated with anxiety disorders, mixed symptoms, melancholic symptoms and a wider use of quetiapine and lamotrigine.
LIMITATIONS: Few prospective studies. Variability in some results.
CONCLUSION: PP may be useful as a supplement to current BD classifications. We have found consistent data on a great number of studies, but there is also contradictory information regarding PP. Further studies are needed, ideally of a prospective design and with a unified methodology.

Language: en

Keywords

Humans; Socioeconomic Factors; Anxiety; Depression; Comorbidity; Prevalence; Europe; Bipolar disorder; Bipolar Disorder; Depressive; Global Health; Predominant polarity; Manic; Trastorno bipolar; Polaridad predominante; Depresivo; Maníaco