Journal
BIOLOGICAL PSYCHIATRY
Volume 58, Issue 7, Pages 549-553Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/j.biopsych.2005.07.029
Keywords
bipolar disorder; depression; age of onset; polarity; chronic
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Funding
- NIMH NIH HHS [N01MH80001] Funding Source: Medline
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Background: We examined the hypothesis that a first depressive rather than manic episode in bipolar disorder might herald a subsequent course notable for greater burden of depressive symptoms. Methods: We analyzed retrospective data on the polarity of first mood episode obtained from 704 bipolar I subjects entering the multicenter Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD) study. Subjects with an initial manic or depressive episode and those in whom both poles occurred within the same year were compared. Results: Depressive-onset bipolar disorder was more common in women and those with earlier onset of illness. Adjusting for these differences. it was significantly associated with more lifetime depressive episodes and a greater proportion of time with depression and anxiety in the year prior to study entry. Conclusions: Polarity of first mood episode may be useful in distinguishing subsets of bipolar patients at risk for a more chronic course.
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