OBJECTIVES: Identifying factors predictive of long-term morbidity should improve clinical planning limiting disability and mortality associated with bipolar disorder (BD). METHODS: We analyzed factors associated with total, depressive and mania-related long-term morbidity and their ratio D/M, as %-time ill between a first-lifetime major affective episode and last follow-up of 207 BD subjects. Bivariate comparisons were followed by multivariable linear regression modeling. RESULTS: Total % of months ill during follow-up was greater in 96 BD-II (40.2%) than 111 BD-I subjects (28.4%; P=0.001). Time in depression averaged 26.1% in BD-II and 14.3% in BD-I, whereas mania-related morbidity was similar in both, averaging 13.9%. Their ratio D/M was 3.7-fold greater in BD-II than BD-I (5.74 vs. 1.96; P<0.0001). Predictive factors independently associated with total %-time ill were: [a] BD-II diagnosis, [b] longer prodrome from antecedents to first affective episode, and [c] any psychiatric comorbidity. Associated with %-time depressed were: [a] BD-II diagnosis, [b] any antecedent psychiatric syndrome, [c] psychiatric comorbidity, and [d] agitated/psychotic depressive first affective episode. Associated with %-time in mania-like illness were: [a] fewer years ill and [b] (hypo)manic first affective episode. The long-term D/M morbidity ratio was associated with: [a] anxious temperament, [b] depressive first episode, and [c] BD-II diagnosis. CONCLUSIONS: Long-term depressive greatly exceeded mania-like morbidity in BD patients. BD-II subjects spent 42% more time ill overall, with a 3.7-times greater D/M morbidity ratio, than BD-I. More time depressed was predicted by agitated/psychotic initial depressive episodes, psychiatric comorbidity, and BD-II diagnosis. Longer prodrome and any antecedent psychiatric syndrome were respectively associated with total and depressive morbidity.

Early clinical predictors and correlates of long-term morbidity in bipolar disorder / Serra, Giulia; Koukopoulos, Alexia; DE CHIARA, Lavinia; Koukopoulos, A. E.; Sani, Gabriele; Tondo, L.; Girardi, Paolo; Reginaldi, D.; Baldessarini, R. J.. - In: EUROPEAN PSYCHIATRY. - ISSN 0924-9338. - STAMPA. - 43:(2017), pp. 35-43. [10.1016/j.eurpsy.2017.02.480]

Early clinical predictors and correlates of long-term morbidity in bipolar disorder

SERRA, GIULIA;KOUKOPOULOS, ALEXIA;DE CHIARA, LAVINIA;SANI, Gabriele;GIRARDI, Paolo;
2017

Abstract

OBJECTIVES: Identifying factors predictive of long-term morbidity should improve clinical planning limiting disability and mortality associated with bipolar disorder (BD). METHODS: We analyzed factors associated with total, depressive and mania-related long-term morbidity and their ratio D/M, as %-time ill between a first-lifetime major affective episode and last follow-up of 207 BD subjects. Bivariate comparisons were followed by multivariable linear regression modeling. RESULTS: Total % of months ill during follow-up was greater in 96 BD-II (40.2%) than 111 BD-I subjects (28.4%; P=0.001). Time in depression averaged 26.1% in BD-II and 14.3% in BD-I, whereas mania-related morbidity was similar in both, averaging 13.9%. Their ratio D/M was 3.7-fold greater in BD-II than BD-I (5.74 vs. 1.96; P<0.0001). Predictive factors independently associated with total %-time ill were: [a] BD-II diagnosis, [b] longer prodrome from antecedents to first affective episode, and [c] any psychiatric comorbidity. Associated with %-time depressed were: [a] BD-II diagnosis, [b] any antecedent psychiatric syndrome, [c] psychiatric comorbidity, and [d] agitated/psychotic depressive first affective episode. Associated with %-time in mania-like illness were: [a] fewer years ill and [b] (hypo)manic first affective episode. The long-term D/M morbidity ratio was associated with: [a] anxious temperament, [b] depressive first episode, and [c] BD-II diagnosis. CONCLUSIONS: Long-term depressive greatly exceeded mania-like morbidity in BD patients. BD-II subjects spent 42% more time ill overall, with a 3.7-times greater D/M morbidity ratio, than BD-I. More time depressed was predicted by agitated/psychotic initial depressive episodes, psychiatric comorbidity, and BD-II diagnosis. Longer prodrome and any antecedent psychiatric syndrome were respectively associated with total and depressive morbidity.
2017
bipolar disorder; D/M ratio; long-term morbidity; outcome; prediction; prodrome; psychiatry and mental health
01 Pubblicazione su rivista::01a Articolo in rivista
Early clinical predictors and correlates of long-term morbidity in bipolar disorder / Serra, Giulia; Koukopoulos, Alexia; DE CHIARA, Lavinia; Koukopoulos, A. E.; Sani, Gabriele; Tondo, L.; Girardi, Paolo; Reginaldi, D.; Baldessarini, R. J.. - In: EUROPEAN PSYCHIATRY. - ISSN 0924-9338. - STAMPA. - 43:(2017), pp. 35-43. [10.1016/j.eurpsy.2017.02.480]
File allegati a questo prodotto
File Dimensione Formato  
Serra_Early-clinical_2017.pdf

accesso aperto

Tipologia: Documento in Post-print (versione successiva alla peer review e accettata per la pubblicazione)
Licenza: Tutti i diritti riservati (All rights reserved)
Dimensione 365.8 kB
Formato Adobe PDF
365.8 kB Adobe PDF

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/961707
Citazioni
  • ???jsp.display-item.citation.pmc??? 9
  • Scopus 14
  • ???jsp.display-item.citation.isi??? 14
social impact