Differentiation in the Preonset Phases of Schizophrenia and Mood Disorders: Evidence in Support of a Bipolar Mania Prodrome

Correll, Christoph U.; Penzner, Julie B.; Frederickson, Anne M.; Richter, Jessica J.; Auther, Andrea M.; Smith, Christopher W.; Kane, John M.; Cornblatt, Barbara A.

doi:10.1093/schbul/sbm028

Cited by 175 publications

(177 citation statements)

References 73 publications

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“…Schizophrenia (SCH) and bipolar affective disorder (BAD) are two psychological disorders that are associated with insufficient clinical response, a chronic recurring course and an inadequate level of functioning in a significant number of patients (Correll et al 2007, Jones et al 2006). …”

Section: Introductionmentioning

confidence: 99%

Schizophrenia and Bipolar Affective Disorder: A Dimensional Approach

et al. 2017

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Section: Introductionmentioning

confidence: 99%

Schizophrenia and Bipolar Affective Disorder: A Dimensional Approach

et al. 2017

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“…Indeed work on both mood (Correll et al, 2007) and personality disorders (Chanen et al, 2008;Miller et al, 2008) each independently suggest mood swings and episodic changes in mood can be the earliest signs of illness.…”

Section: Introductionmentioning

confidence: 99%

The prevalence and clinical associations of mood instability in adults living in England: Results from the Adult Psychiatric Morbidity Survey 2007

Marwaha

Parsons

Flanagan

et al. 2013

Psychiatry Research

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Mood instability is under investigated but potentially clinically important. This study aimed to describe the prevalence of mood instability in adults living in England and test whether it is important in explaining the extent of symptoms of common mental disorders, suicidality and healthcare use. An analysis of data from the Adult Psychiatric Morbidity Survey 2007, a household survey of private households in England (N=7403) was completed. The prevalence of mood instability was 13.9%. In univariate analysis it was strongly associated with socio-demographic and clinical variables. In regression modelling mood instability was 3 independently associated with non-psychotic psychopathology increasing the odds by 9.89.It was also linked with suicidal ideas (OR: 2.04) but not suicidal acts, and associated with being in receipt of medication, counselling or therapy for mental health problems (OR:1.88), independent of a diagnosis of Borderline Personality Disorder. Mood instability is relatively common in the adult population, occurs frequently in common mental disorders and appears to be an important symptom in its own right. It is associated with two important measures in psychiatry, namely suicidal thinking and healthcare service use. It warrants more widespread recognition and further research is required to understand if, when and how to intervene.

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“…Generally, the prodrome was subacute or insidious, corroborating the findings of a previous study that systematically investigated the prodromal period of individuals with early-onset BD. 11 This relatively long period of mild symptoms before the first mood episode and, specifically, before the first episode of mania is relevant, because it suggests a possibility of recognizing and trialing possible interventions to prevent or delay the first manic episode. Interpreted more conservatively, this finding suggests that individuals in putatively prodromal stages might at least be protected from exposure to potentially deleterious interventions, such as administration of antidepressants or psychostimulants without mood-stabilizing agents.…”

Section: Discussionmentioning

confidence: 99%

“…Regarding onset pattern, the prodrome was classified as acute (o 1 month in duration), subacute (1-12 months in duration), or insidious (4 1 year in duration). 11 Prodromal symptoms that emerged prior to the first depressive or manic/ hypomanic episode were systematically investigated through retrospective patient reports.…”

Section: Assessment Instrumentsmentioning

confidence: 99%

Clinical characteristics and influence of childhood trauma on the prodrome of bipolar disorder

Noto

Caribé

et al. 2015

Rev. Bras. Psiquiatr.

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Objectives: To describe the onset pattern, frequency, and severity of the signs and symptoms of the prodrome of the first hypomanic/manic episode and first depressive episode of bipolar disorder (BD) and to investigate the influence of a history of childhood maltreatment on the expression of prodromal symptoms. Methods: Using a semi-structured interview, the Bipolar Prodrome Symptom Scale-Retrospective (BPSS-R), information regarding prodromal symptoms was assessed from patients with a DSM-IV diagnosis of BD. History of childhood maltreatment was evaluated using the Childhood Trauma Questionnaire (CTQ). Results: Forty-three individuals with stable BD were included. On average, the prodrome of mania lasted 35.8668.7 months and was predominantly subacute or insidious, with rare acute presentations. The prodrome of depression lasted 16.6623.3 months and was also predominantly subacute or insidious, with few acute presentations. The prodromal symptoms most frequently reported prior to the first hypomanic or manic episode were mood lability, depressive mood, and impatience. A history of childhood abuse and neglect was reported by 81.4% of participants. Presence of childhood maltreatment was positively associated with prodromal symptoms, including social withdrawal, decreased functioning, and anhedonia. Conclusions: This study provides evidence of a long-lasting, symptomatic prodrome prior to first hypomanic/manic and depressive episode in BD and suggests that a history of childhood maltreatment influences the manifestations of this prodrome.

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Differentiation in the Preonset Phases of Schizophrenia and Mood Disorders: Evidence in Support of a Bipolar Mania Prodrome

Abstract: A lengthy and symptomatic prodrome makes clinical high-risk research a feasible goal for bipolar disorder. The phenotypic overlap with the schizophrenia prodrome necessitates the concurrent study of both illness prodromes.

Cited by 175 publications

References 73 publications

Schizophrenia and Bipolar Affective Disorder: A Dimensional Approach

Schizophrenia and Bipolar Affective Disorder: A Dimensional Approach

The prevalence and clinical associations of mood instability in adults living in England: Results from the Adult Psychiatric Morbidity Survey 2007

Clinical characteristics and influence of childhood trauma on the prodrome of bipolar disorder

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