Differences in Demographic and Clinical Characteristics of Patients With Depressive vs. Manic First Episode of Bipolar Disorder

Abstract

Background: Bipolar disorder is a serious mental disease marked by episodes of depression, mania, hypomania, or mixed states. Patients with bipolar disorder may present with different symptoms at first onset. The aim of this study is to compare demographic and clinical variables based on a patient's first episode of bipolar disorder, including risk of recurrence over a 2-year period.Methods: A large cohort (N = 742) of patients with bipolar disorder in China was analyzed. Patients were divided into two groups according to their first episode of bipolar disorder, either depression or mania. Patients in mixed state first episode were classified based on predominant symptoms. Three hundred eighteen patients of the cohort had a first episode of mania and 424 patients had initial symptoms of depression. Demographic and clinical data were collected. All patients were followed up for 24 months. Data on compliance with follow-up appointments and recurrence of symptoms after 6, 12, 18, and 24 months were collected. Clinical characteristics (course of disease, age of onset, psychiatric family history, etc.) were compared between the mania group and depression groups.Results: More patients with bipolar disorder had a first episode of depression than mania (57.14 vs. 42.86%). Compared with the depression group, the mania group had later age of diagnosis of bipolar disorder [(38.64 ± 13.50) vs. (36.34 ± 14.94), P = 0.028], lower education level [(9.37 ± 4.34) vs. (10.17 ± 4.81), P = 0.017] and longer latency between an initial episode of psychiatric symptoms and formal bipolar diagnosis [(10.80 ± 10.76) vs. (8.85 ± 9.90), P = 0.012]. More patients in the mania group were male and without psychotic symptoms (all P < 0.05). In comparison with the mania group, more patients in the depression group were female, with higher frequency of a reported precipitating event before first mood episode (all P < 0.05). Compared with the depression group, the mania group had more recurrences of illness at the end of 12 months (Z =-2.156, P = 0.031), 18 months (Z =-2.192, P = 0.028), and 24 months (Z = −2.364, P = 0.018).Conclusions: In our study, there are a number of differences in demographic and clinical characteristics of patients with different onset syndromes of bipolar disorder. These differences include gender, education level, diagnosis age, the rate of recurrences, and others. These data of a cohort of Chinese patients add to the growing international literature on the relationship between index episode of bipolar disorder and clinical variables and outcomes. These results and further study may allow clinicians to offer patients and families more reliable prognostic information at the onset of disease.

Clinical characteristics and cognitive function in bipolar disorder patients with different onset symptom

“…Our study showed that the first symptoms of BD patients are mainly depressive episodes (56.55% vs.43.45%). Our previous study ( 29 ) supported this point. Compared with the first mania group, the first depression groups had more earlier onset age.…”

Questioning the role of palmitoylethanolamide in psychosis: a systematic review of clinical and preclinical evidence

“…Instead, the occurrence of positive psychotic symptoms, manic symptoms, and hypomanic episodes, was correlated with reduced PEA tone ( 50 ). Based on evidence that BPAD patients with manic onset have an older age at diagnosis and a longer duration of untreated illness than those with depressive onset ( 58 ), and that polarity of episodes over time often reflects polarity at onset ( 59 ), such different findings among BPAD patients may suggest a changing pattern in PEA levels over time. In other words, PEA plasma levels would be higher in the first phases of the disorder, while declining because of disease progression, in line with what observed for non-affective psychosis, and thus strengthening the rationale for its supplementation.…”

The correlation between bipolar disorder not otherwise specified progression with patients’ clinical and demographic characteristics

“…No statistically significant association was found between the duration of symptoms onset to patients' hospitalization with mania and mixed symptoms with the level of education. Wang et al in their study found that, the correlation between the level of education and treatment adherence in patients diagnosed with bipolar disorder has been ascertained as a plausible prognosticator (22). Bipolar disorder is a multifaceted psychological ailment distinguished by occurrences of mania, hypomania, depression, or mixed states.…”

“…Bipolar disorder is a multifaceted psychological ailment distinguished by occurrences of mania, hypomania, depression, or mixed states. The time span between the manifestation of symptoms and the admission of patients with mania and mixed symptoms could potentially be impacted by diverse elements, such as demographic, clinical, and psychosocial determinants (22).…”