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Polarity at illness onset in bipolar I disorder and clinical course of illness
Author(s) -
Forty Liz,
Jones Lisa,
Jones Ian,
Smith Daniel J,
Caesar Sian,
Fraser Christine,
GordonSmith Katherine,
Hyde Sally,
Craddock Nick
Publication year - 2009
Publication title -
bipolar disorders
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.285
H-Index - 129
eISSN - 1399-5618
pISSN - 1398-5647
DOI - 10.1111/j.1399-5618.2008.00654.x
Subject(s) - bipolar disorder , bipolar illness , psychiatry , age of onset , psychology , bipolar i disorder , logistic regression , major depressive disorder , polarity (international relations) , bipolar ii disorder , major depressive episode , mental illness , clinical psychology , mania , medicine , mood , disease , mental health , genetics , biology , cell
Objectives: Studies have suggested that episode polarity at illness onset in bipolar disorder may be predictive of some aspects of lifetime clinical characteristics. We here examine this possibility in a large, well‐characterized sample of patients with bipolar I disorder. Methods: We assessed polarity at onset in patients with bipolar I disorder (N = 553) recruited as part of our ongoing studies of affective disorders. Lifetime clinical characteristics of illness were compared in patients who had a depressive episode at first illness onset (n = 343) and patients who had a manic episode at first illness onset (n = 210). Results: Several lifetime clinical features differed between patients according to the polarity of their onset episode of illness. A logistic regression analysis showed that the lifetime clinical features significantly associated with a depressive episode at illness onset in our sample were: an earlier age at illness onset; a predominantly depressive polarity during the lifetime; more frequent and more severe depressive episodes; and less prominent lifetime psychotic features. Conclusions: Knowledge of pole of onset may help the clinician in providing prognostic information and management advice to an individual with bipolar disorder.