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Polarity of the First Episode and Time to Diagnosis of Bipolar I Disorder

Cited 21 time in Web of Science Cited 25 time in Scopus
Authors

Cha, Boseok; Kim, Jeong Hyun; Ha, Tae Hyon; Chang, Jae Seung; Ha, Kyooseob

Issue Date
2009-06
Publisher
KOREAN NEUROPSYCHIATRIC ASSOC
Citation
PSYCHIATRY INVESTIGATION; Vol.6(2); 96-101
Keywords
Bipolar disorderSuicideDiagnosisPolarityFirst episode
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.
ISSN
1738-3684
Language
English
URI
https://hdl.handle.net/10371/78566
DOI
https://doi.org/10.4306/pi.2009.6.2.96
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