The impact of the number of episodes on the outcome of Bipolar Disorder

Marzo, S. Di; Giordano, Annalisa; Pacchiarotti, Isabella; Colom, Francesc; Sánchez-Moreno, José; Vieta, Eduard

doi:10.4321/s0213-61632006000100003

Cited by 18 publications

(16 citation statements)

References 36 publications

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“…Consistent with previous research (18), we dichotomized number of lifetime depressive and manic/hypomanic episodes as "few" (≤ 5) versus "many" (> 5) because the accuracy of reporting likely decreases with an increasing number of mood episodes, and there is some evidence that having more than 10 total mood episodes (depressive + manic/hypomanic) is associated with greater functional impairment in bipolar patients (19).…”

Section: Data Analysesmentioning

confidence: 73%

Eating disorders and illness burden in patients with bipolar spectrum disorders

Wildes

Marcus

Fagiolini

2007

Comprehensive Psychiatry

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Objectives-To evaluate the clinical significance of lifetime eating disorder co-morbidity in a welldefined sample of patients with bipolar spectrum disorders and to describe cognitive correlates of disordered eating in this group.Method-Twenty-six bipolar patients with a lifetime history of a DSM-IV defined eating disorder (n = 17) or a clinically significant subthreshold eating disorder (n = 9) (ED group) were compared to 46 bipolar patients with no history of an eating disorder (No ED group) on demographic and clinical characteristics at study presentation, history of bipolar illness, and other psychiatric co-morbidity. Measures included the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I), the Clinical Global Impression-Severity Scale-Bipolar Version (CGI-S-BP), and the Eating Disorder Examination (EDE). Height and weight were recorded to calculate body mass index (BMI).Results-Patients in the ED group were heavier and were rated as more symptomatic on the CGI-S-BP than were patients in the No ED group. The ED group also had a higher number of lifetime depressive episodes and greater psychiatric co-morbidity, excluding eating and mood disorders. Finally, after controlling for BMI and CGI-S-BP rating, patients in the ED group had significantly higher EDE Restraint, Eating Concern, Shape Concern, Weight Concern, and Global scores than did patients in the No ED group.Conclusions-These findings highlight the need for a renewed emphasis on the evaluation and management of weight and eating in the mood disorders. In particular, this research suggests that eating disorder co-morbidity may be a marker for increased symptom load and illness burden in bipolar disorder.

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Section: Data Analysesmentioning

confidence: 73%

Eating disorders and illness burden in patients with bipolar spectrum disorders

Wildes

Marcus

Fagiolini

2007

Comprehensive Psychiatry

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“…Established correlates of quality of life include the number of previous episodes of depression and mania (Di Marzo et al, 2006; Dickerson et al, 2004), severity of current symptoms (Atkinson et al, 1997), lower educational attainment (Kessler et al, 1995), and neurocognitive deficits (Altshuler et al, 2007). Although these variables have a moderate link with quality of life in bipolar disorder, much of the variance remains unexplained.…”

Section: Introductionmentioning

confidence: 99%

Emotion perception and quality of life in bipolar I disorder

Fulford

Peckham

Johnson

et al. 2014

Journal of Affective Disorders

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Background Across two studies we examined the role of emotion perception as a correlate of quality of life and occupational functioning in bipolar I disorder. Method In Study 1, we tested a multifactorial model of quality of life and occupational functioning, including the role of emotion perception and other established correlates of functional outcomes, among 42 participants diagnosed with bipolar I disorder. In Study 2, participants diagnosed with bipolar I disorder and age- and gender-matched controls completed an affect recognition task and a quality of life measure. Results Across both studies, emotion perception related to functional outcomes. In Study 1, self-rated emotion perception explained unique variance in subjective well-being after controlling for illness characteristics, education, and executive function. In Study 2, a behavioral measure of facial affect recognition accuracy was related to quality of life, even after controlling for illness severity. Limitations Limitations include the use of a cross-sectional design, relatively small sample sizes, and the focus on only one aspect of social cognition. Conclusions Findings indicate that emotion perception may protect quality of life in bipolar disorder. This dimension may help predict important outcomes and, with further research, could serve as a potential treatment target.

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“…Moreover, it appears that a substantial number of individuals with BPII experience various clinical correlates of suicide risk at least as often as do individuals with BPI. These include (i) impairment and disruption in social and occupational functioning (4,16,17); (ii) self-blame and hopelessness during depression (18)(19)(20); (iii) state and trait impulsivity (16,19,(21)(22)(23); (iv) recurrent, persistent, and severe depressions (24)(25)(26); (v) comorbid substance-abuse disorders (16,27); (vi) comorbid anxiety disorders (28)(29)(30); (vii) subsyndromal mixed states (23,31); (viii) suicidal ideation (7,15,32,33); and (ix) inappropriate treatment due to under diagnosis or misdiagnosis (4,21,34,35). If the morbidity of BPII is at least comparable to the documented disease burden associated with BPI, and if BPII is associated with clinical correlates of suicide risk as often as BPI, then one would expect comparable rates of attempted suicide across bipolar subtypes.…”

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confidence: 99%

Suicide attempts in bipolar I and bipolar II disorder: a review and meta‐analysis of the evidence

2010

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Objective The prevalence of suicide attempts (SA) in bipolar II disorder (BPII), particularly in comparison to the prevalence in bipolar I disorder (BPI), is an understudied and controversial issue with mixed results. To date, there has been no comprehensive review of the published prevalence data for attempted suicide in BPII. Methods We conducted a literature review and meta-analysis of published reports that specified the proportion of individuals with BPII in their presentation of SA data. Systematic searching yielded 24 reports providing rates of SA in BPII and 21 reports including rates of SA in both BPI and BPII. We estimated the prevalence of SA in BPII by combining data across reports of similar designs. To compare rates of SA in BPII and BPI, we calculated a pooled odds ratio (OR) and 95% confidence interval (CI) with random-effect meta-analytic techniques with retrospective data from 15 reports that detailed rates of SA in both BPI and BPII. Results Among the 24 reports with any BPII data, 32.4% (356 /1099) of individuals retrospectively reported a lifetime history of SA, 19.8% (93 /469) prospectively reported attempted suicide, and 20.5% (55 /268) of index attempters were diagnosed with BPII. In 15 retrospective studies suitable for meta-analysis, the prevalence of attempted suicide in BPII and BPI was not significantly different: 32.4% and 36.3%, respectively (OR = 1.21, 95% CI: 0.98–1.48, p = 0.07). Conclusion The contribution of BPII to suicidal behavior is considerable. Our findings suggest that there is no significant effect of bipolar subtype on rate of SA. Our findings are particularly alarming in concert with other evidence, including (i) the well-documented predictive role of SA for completed suicide and (ii) the evidence suggesting that individuals with BPII use significantly more violent and lethal methods than do individuals with BPI. To reduce suicide-related morbidity and mortality, routine clinical care for BPII must include ongoing risk assessment and interventions targeted at risk factors.

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The impact of the number of episodes on the outcome of Bipolar Disorder

Cited by 18 publications

References 36 publications

Eating disorders and illness burden in patients with bipolar spectrum disorders

Eating disorders and illness burden in patients with bipolar spectrum disorders

Emotion perception and quality of life in bipolar I disorder

Suicide attempts in bipolar I and bipolar II disorder: a review and meta‐analysis of the evidence

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