Better and earlier predictive differentiation of bipolar (BD) vs. unipolar major depressive disorder (UD) diagnoses should improve long-term clinical planning.We reviewed randomly selected clinical records of 334 adults diagnosed with DSM-IV-TR BD-I (n=109), BD-II (n=106), and UD (n=119) and compared features preceding major affective episodes or diagnoses, using bivariate, multivariate, and Bayesian methods.We identified antecedents selectively associated with later BD vs. UD in 52.6\% vs. 31.1\% of subjects in childhood, starting at age 7.4 years, and 60.0\% vs. 32.8\% in adolescence, with far more features in BD than UD cases (10.3 vs. 4.64/100 person-years; p<0.001). In multivariate modeling, BD-selective factors were: younger at first clinical event > male sex > family BD-history > cyclothymic or hyperthymic temperament > antecedents/person-year. Nonaffective (anxiety, eating, or substance-use) disorders preceded BD vs. UD in 41.4\% vs. 28.6\% of subjects (p=0.02). By ROC analysis, differential prediction of BD vs. UD was optimal with any ≥3 factors/person.The validity and timing of antecedent events and factors identified retrospectively from clinical records could not be verified independently, but information was recorded systematically and consistently by a single mood-disorder expert prior to diagnosis, and extracted by two independent observers.Early clinical features distinguished later BD from UD, often by years. Such prediction should improve treatment-planning and limit risk of mood-switching.

Features preceding diagnosis of bipolar versus major depressive disorders / Serra, Giulia; A., Koukopoulos; DE CHIARA, Lavinia; F., Napoletano; Koukopoulos, Alexia; Curto, Martina; G., Manfredi; G., Faedda; Girardi, Paolo; R. J., Baldessarini. - In: JOURNAL OF AFFECTIVE DISORDERS. - ISSN 0165-0327. - STAMPA. - 173:(2015), pp. 134-142. [10.1016/j.jad.2014.10.050]

Features preceding diagnosis of bipolar versus major depressive disorders

SERRA, GIULIA;DE CHIARA, LAVINIA;KOUKOPOULOS, ALEXIA;CURTO, MARTINA;GIRARDI, Paolo;
2015

Abstract

Better and earlier predictive differentiation of bipolar (BD) vs. unipolar major depressive disorder (UD) diagnoses should improve long-term clinical planning.We reviewed randomly selected clinical records of 334 adults diagnosed with DSM-IV-TR BD-I (n=109), BD-II (n=106), and UD (n=119) and compared features preceding major affective episodes or diagnoses, using bivariate, multivariate, and Bayesian methods.We identified antecedents selectively associated with later BD vs. UD in 52.6\% vs. 31.1\% of subjects in childhood, starting at age 7.4 years, and 60.0\% vs. 32.8\% in adolescence, with far more features in BD than UD cases (10.3 vs. 4.64/100 person-years; p<0.001). In multivariate modeling, BD-selective factors were: younger at first clinical event > male sex > family BD-history > cyclothymic or hyperthymic temperament > antecedents/person-year. Nonaffective (anxiety, eating, or substance-use) disorders preceded BD vs. UD in 41.4\% vs. 28.6\% of subjects (p=0.02). By ROC analysis, differential prediction of BD vs. UD was optimal with any ≥3 factors/person.The validity and timing of antecedent events and factors identified retrospectively from clinical records could not be verified independently, but information was recorded systematically and consistently by a single mood-disorder expert prior to diagnosis, and extracted by two independent observers.Early clinical features distinguished later BD from UD, often by years. Such prediction should improve treatment-planning and limit risk of mood-switching.
2015
adolescent; antecedent; bipolar disorder; child; major depression; prodome
01 Pubblicazione su rivista::01a Articolo in rivista
Features preceding diagnosis of bipolar versus major depressive disorders / Serra, Giulia; A., Koukopoulos; DE CHIARA, Lavinia; F., Napoletano; Koukopoulos, Alexia; Curto, Martina; G., Manfredi; G., Faedda; Girardi, Paolo; R. J., Baldessarini. - In: JOURNAL OF AFFECTIVE DISORDERS. - ISSN 0165-0327. - STAMPA. - 173:(2015), pp. 134-142. [10.1016/j.jad.2014.10.050]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/751019
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