Polarity of the First Episode and Time to Diagnosis of Bipolar I Disorder.
- Author:
Boseok CHA
1
;
Jeong Hyun KIM
;
Tae Hyon HA
;
Jae Seung CHANG
;
Kyooseob HA
Author Information
1. Mood Disorders Clinic and Clinical Affective Neuroscience Laboratory, Department of Psychiatry, Seoul National University Bundang Hospital, Seongnam, Korea.
- Publication Type:Original Article
- Keywords:
Bipolar disorder;
Polarity;
First episode;
Diagnosis;
Suicide
- MeSH:
Bipolar Disorder;
Depressive Disorder, Major;
Diagnostic and Statistical Manual of Mental Disorders;
Humans;
Inpatients;
Medical Records;
Schizophrenia;
Suicide
- From:Psychiatry Investigation
2009;6(2):96-101
- CountryRepublic of Korea
- Language:English
-
Abstract:
OBJECTIVE: The current study explored the relationship between the polarity of the first episode and the timing of eventual diagnosis of bipolar I disorder, and associated clinical implications. METHODS: Twelve years of clinical data from the medical records of 258 inpatients meeting DSM-III-R or DSM-IV criteria for bipolar I disorder were analyzed. Subjects were divided into two groups according to the polarity of the first episode: those with depressive polarity (FE-D), and those with manic polarity (FE-M). Comparisons were made between the two groups on variables associated with the timing of diagnosis and related outcomes. RESULTS: In population with bipolar I disorder, a significant longer time lapse from the first major mood episode to the confirmed diagnosis was associated with the FE-D group compared to the FE-M group [5.6 (+/-6.1) vs. 2.5 (+/-5.5) years, p<0.001]. FE-D subjects tended to have prior diagnoses of schizophrenia and major depressive disorder while FE-M subjects tended to have prior diagnoses of bipolar disorder and schizophrenia. A significantly higher rate of suicide attempts was associated with the FE-D group compared to the FE-M group (12.7 vs. 1.7%, p<0.001). CONCLUSION: The results of this study indicate that first-episode depressive polarity is likely to be followed by a considerable delay until an eventual confirmed diagnosis of bipolar I disorder. Given that first-episode depressive patients are particularly vulnerable to unfavorable clinical outcomes such as suicide attempts, a more systematic approach is needed to differentiate bipolar disorder among depressed patients in their early stages.
