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International Journal of Bipolar Disorders

, 5:2

First Online: 25 January 2017Received: 05 October 2016Accepted: 04 January 2017

Abstract

BackgroundBipolar disorder BD is a chronic, frequently comorbid condition characterized by high rates of mood episode recurrence and suicidality. Little is known about prospective longitudinal characterization of BD type II BD II versus type I BD I in relation to time to depressive recurrence and recovery from major depressive episode. We therefore assessed times to depressive recurrence-recovery in tertiary clinic-referred BD II versus I patients.

MethodsOutpatients referred to Stanford BD Clinic during 2000–2011 were assessed with Systematic Treatment Enhancement Program for BD STEP-BD Affective Disorders Evaluation and with Clinical Monitoring Form during up to 2 years of naturalistic treatment. Prevalence and clinical correlates of bipolar subtype in recovered euthymic ≥8 weeks and depressed patients were assessed. Kaplan–Meier analyses assessed the relationships between bipolar subtype and longitudinal depressive severity, and Cox proportional hazard analyses assessed the potential mediators.

ResultsBD II versus BD I was less common among 105 recovered 39.0 vs. 61.0%, p = 0.03 and more common among 153 depressed 61.4 vs. 38.6%, p = 0.006 patients. Among recovered patients, BD II was associated with 6-25 24.0% baseline unfavorable illness characteristics-mood symptoms-psychotropics and hastened depressive recurrence p = 0.015. Among depressed patients, BD II was associated with 8-25 33.0% baseline unfavorable illness characteristics-mood symptoms-psychotropics, but only non-significantly associated with delayed depressive recovery.

ConclusionsBD II versus BD I was significantly associated with current depression and hastened depressive recurrence, but only non-significantly associated with delayed depressive recovery. Research on bipolar subtype relationships with depressive recurrence-recovery is warranted to enhance clinical management of BD patients.

KeywordsBipolar disorder Bipolar subtype Time to depressive recurrence Time to recovery AbbreviationsBDbipolar disorder

BD Ibipolar disorder type I

BD IIbipolar disorder type II

CGI-BP-OSclinical global impression for bipolar disorder-overall severity

CIconfidence interval

CMFclinical monitoring form

dfdegrees of freedom

HRhazard ratio

MINImini international neuropsychiatric interview

SCID for DSM-IVstructured clinical interview for the diagnostic and statistical manual of mental disorders, IVth edition

SDstandard deviation

SPSSStatistical Package for the Social Sciences

STEP-BDsystematic treatment enhancement program for bipolar disorder

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Autor: Bernardo Dell’Osso - Saloni Shah - Dennis Do - Laura D. Yuen - Farnaz Hooshmand - Po W. Wang - Shefali Miller - Terence

Fuente: https://link.springer.com/







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