Impact of predominant polarity on long-term outcome in bipolar disorder: A 7-year longitudinal cohort study

Belizário, Gabriel Okawa; Silva, Michelle; Lafer, Beny

doi:10.1016/j.jad.2018.07.086

Cited by 17 publications

(22 citation statements)

References 14 publications

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“…They also spent less time in MDEs and more in manic states. However, probably since there are multiple indications for hospitalization among BD patients, contrary to study of Belizario et al (Belizario et al, 2018), this did not lead to higher frequency of hospitalizations. In specific subgroup analyses, the differences in time ill were significant in the BD I group, but for the BD II group the findings persisted only for the time spent in MDEs, almost reaching significance also for the time spent euthymic.…”

Section: Discussioncontrasting

confidence: 68%

“…In contrast, Azorin et al (Azorin et al, 2015) found the MP group to have more suicide attempts and explained this by higher levels of cyclothymic and hyperthymic temperaments in MP. A 7-year longitudinal cohort study also found higher number of SAs in the MP group (Belizario et al, 2018).…”

Section: Introductionmentioning

confidence: 83%

“…Some studies have applied a less strict definition of simply having more lifetime episodes of either manic or depressive polarity Forty et al, 2009;Gonzalez-Pinto et al, 2010), whereas most studies have used the definition of Colom et al (Colom et al, 2006;Rosa et al, 2008;Garcia-Lopez et al, 2009;Mazzarini et al, 2009;Vieta et al, 2009;Murru et al, 2011;Nivoli et al, 2011;Popovic et al, 2014;Belizario et al, 2018;Vidal-Rubio et al, 2018), and only a few both (Baldessarini and Salvatore et al2012;Azorin et al, 2015). When defining the polarity, mixed episodes are excluded in most studies.…”

Section: Introductionmentioning

confidence: 99%

“…The concept of predominant polarity was created to help clinicians in planning optimal treatment based on the expected illness course in light of the past. However, only a few prospective studies have thus far been conducted (Garcia-Lopez et al, 2009;Gonzalez-Pinto et al, 2010;Belizario et al, 2018), and the actual predictive validity of the classification remains uncertain. Furthermore, the predominant polarity is defined based on the ratio of illness episodes.…”

Section: Introductionmentioning

confidence: 99%

“…Moreover, the predominant polarities could be regarded as a continuum between the extremes of manic and depressive polarity, with "no predominant polarity" (no polarity, NP) as an intermediate group (Angst, 1978;Angst, 2007;Qiu et al, 2017). This dimensional view of predominant polarity and the role of the intermediate no polarity group has been only recently addressed in the literature (Belizario et al, 2018;Vidal-Rubio et al, 2018).…”

Section: Introductionmentioning

confidence: 99%

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Predominant polarity in bipolar I and II disorders: a five-year follow-up study

Pallaskorpi

Suominen²,

Rosenström

et al. 2019

European Neuropsychopharmacology

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Background: Patients with bipolar disorder (BD) differ in their relative predominance of types of episodes, yielding predominant polarity, which has important treatment implications. However, few prospective studies of predominant polarity exist. Methods:In the Jorvi Bipolar Study (JoBS), a regionally representative cohort of 191 BD I and BD II in-and outpatients was followed for five years using life-chart methodology. Differences between depressive (DP), manic (MP), and no predominant polarity (NP) groups were examined regarding time ill, incidence of suicide attempts, and comorbidity.Results: At baseline, 16% of patients had MP, 36% DP, and 48% NP. During the follow-up the MP group spent significantly more time euthymic, less time in major depressive episodes, and more time in manic states than the DP and NP groups. The MP group had significantly lower incidence of suicide attempts than the DP and NP group, lower prevalence of comorbid anxiety disorders but more psychotic symptoms lifetime and more often (hypo)manic first phase of the illness than the DP group. Classification of predominant polarity was influenced by the timeframe used. Limitations:The retrospective counting of former phases is vulnerable to recall bias. Assignment of dominant polarity may necessitate a sufficient number of illness phases. Conclusions:Predominant polarity has predictive value in predicting group differences in course of illness, but individual patients' classification may change over time. Patients with manic polarity may represent a more distinct subgroup than the two others regarding illness course, suicide attempts, and psychiatric comorbidity.

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Section: Discussioncontrasting

confidence: 68%

Section: Introductionmentioning

confidence: 83%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Predominant polarity in bipolar I and II disorders: a five-year follow-up study

Pallaskorpi

Suominen²,

Rosenström

et al. 2019

European Neuropsychopharmacology

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Langzeitverläufe bipolarer Störungen

Czempiel,

Mikolas,

Bauer

et al. 2024

Nervenarzt

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Zusammenfassung Hintergrund Die bipolare Störung (englisch: „bipolar disorder“, kurz: BD) ist eine schwerwiegende Erkrankung mit sehr heterogenen Verlaufsformen. Während ein Teil der Patienten keine oder kaum langfristige Beeinträchtigungen aufweist, zeigt ein anderer Teil der Betroffenen erhebliche neurokognitive Einschränkungen mit deutlichem psychosozialen Funktionsabbau. Welche Faktoren den Krankheitsverlauf beeinflussen, ist Gegenstand aktueller Forschungsbestrebungen. Ziel der Arbeit In dieser Übersichtsarbeit werden der Langzeitverlauf der bipolaren Erkrankung und die ihn beeinflussenden Faktoren dargestellt. Insbesondere wird auf differenzielle Verlaufstypen eingegangen. Das kognitive und psychosoziale Funktionsniveau sowie die psychopathologischen Besonderheiten der Erkrankung werden beleuchtet. Zudem werden biologische Faktoren und Therapieansätze herausgearbeitet, welche den Verlauf und die Prognose beeinflussen. Material und Methoden Literaturrecherche mittels PubMed mit Fokus auf longitudinalen Studien (siehe Onlinezusatzmaterial). Ergebnisse Bis zum aktuellen Zeitpunkt gibt es wenige Prädiktoren und Biomarker, die eine Voraussage über den Langzeitverlauf erlauben. Keiner ist ausreichend untersucht, um den klinischen Einsatz zu ermöglichen. Eine geeignete pharmakologische und psychotherapeutische Behandlung Betroffener ist unerlässlich, um erneute Krankheitsepisoden zu vermeiden. Diskussion Der Langzeitverlauf der bipolaren Störung ist stark heterogen und facettenreich. Trotz intensiver Forschungsbemühungen sind noch keine Prädiktoren identifiziert, welche verlässlich den klinischen Verlauf vorhersagen. Umso wichtiger ist die weitere Erforschung, um individualisierte Therapieangebote zu unterbreiten, neuartige Therapien zu entwickeln und frühzeitig den Verlauf positiv zu beeinflussen.

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