Epidemiological and clinical variables related with the predominant polarity on bipolar disorder: A systematic review

García-Jiménez, Jesús; Álvarez-Fernández, Marisol; Aguado-Bailón, Lidia; Gutiérrez‐Rojas, Luis

doi:10.1016/j.rpsmen.2017.06.003

Cited by 3 publications

(2 citation statements)

References 48 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…According to the latest systematic reviews, a depressive predominant polarity (DPP) is found in 17.0-34.1% (median value: 21.4%) of the BD samples, whilst a manic predominant polarity (MPP) is observed in 12.4-55.0% of participants (median value: 26.0%). Predomi-2 of 11 nant polarity is undetermined in 47.3% of patients with BD (range: 28.2-57.6) [6,7], so the majority of patients with BD cannot be categorized according to this concept.…”

Section: Introductionmentioning

confidence: 99%

“…The definition of MPP and DPP based on two-thirds of episodes [3] is the most consistently used and validated [18][19][20][21][22], but it called for different criticisms [23]. First, it implies a restrictive definition so that the highest percentage of patients, roughly 50% [6,7], end up without having a predominant polarity in the recently clinically characterized category of undetermined predominant polarity (UPP) [20]. Secondly, mixed episodes do not compute clearly into a specific polarity, being included either in MPP [24] or DPP [25].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

The Mixed Tendency in Bipolar Disorder: An Operational Proposal for the Integration of Mixed Episodes in Predominant Polarity

Fico,

Anmella,

De Prisco

et al. 2023

JCM

View full text Add to dashboard Cite

Predominant Polarity (PP) is an established specifier of Bipolar Disorder (BD), holding significant clinical implications. Nevertheless, there exists no consensus on how to incorporate mixed states into PP, leaving patients prone to mixed recurrences that are unclassified. In a comprehensive study involving 701 euthymic BD patients, we sought to redefine PP by introducing a novel metric, the “mixed tendency”, and establish a practical threshold to identify patients with a “mixed phenotype”. Furthermore, we investigated potential associations between the mixed phenotype and specific PP categories. Our findings revealed that the mixed tendency correlated significantly with early BD type I, lifetime suicide attempts, self-aggressive behaviour, and lifetime number of affective episodes (>5). Using a ROC curve analysis, we determined an optimal cut-off point for the mixed tendency at 0.228, suggesting that patients with ~25% of lifetime mixed episodes relative to total affective episodes should be identified as having a mixed phenotype. Notably, the mixed phenotype was positively associated with undetermined PP and negatively with manic and depressive PP. This study introduces a promising approach to incorporating mixed episodes into the PP definition, potentially enabling tailored interventions for patients with a substantial history of mixed episodes. However, further research in large, longitudinal cohorts is essential to validate these findings.

show abstract

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The Mixed Tendency in Bipolar Disorder: An Operational Proposal for the Integration of Mixed Episodes in Predominant Polarity

Fico,

Anmella,

De Prisco

et al. 2023

JCM

View full text Add to dashboard Cite

show abstract

Features Associated With Depressive Predominant Polarity and Early Illness Onset in Patients With Bipolar Disorder

et al. 2020

Self Cite

View full text Add to dashboard Cite

Objective: The aim of this study is to determine the prevalence of three possible diagnostic specifiers, namely predominant polarity (PP) throughout illness, polarity of the first episode and early age at onset, in a sample of bipolar disorder (BD) patients and their association with important socio-demographic, clinical and course-of-illness variables. Methods: A retrospective and naturalistic study on 108 BD outpatients, who were classified according to the PP, polarity of the first episode and early age at onset (≤ 20 years) [vs. late (>20 years)] and were characterized by their demographics, clinical data, functionality and social support, among others features. After bivariate analyses, those variables showing certain association ( P value < 0.25) with the three dependent variables were entered in logistic regression backward selection procedures to identify the variables independently associated with the PP, polarity of the first episode and early age at onset. Results: The sample consisted of 75 women ad 33 men, 74% with type I BD and 26% with type II. Around 70% had depressive PP, onset with a depressive episode and onset after age 20. Depressive PP was independently associated with depressive onset, higher score on the CGI severity scale and work disability. Onset with depressive episode was associated with type II BD, longer diagnostic delay and higher score on family disability. Early age at onset (≤ 20 years) was associate with younger age, longer diagnostic delay, presence of ever psychotic symptoms, current use of antipsychotic drugs and higher social support score. Conclusions: The results of this study show that BD patients with depressive PP, onset with depression and early age at onset may represent greater severity, because they are frequently associated with variables that worsen the prognosis. Our findings match up with the conclusions of two systematic reviews and we also include a disability factor (at family and work) that has not been previously reported. This work contributes to the use of polarity and age at onset in BD patients, as it can become a useful instrument in the prognostic and therapeutic applications.

show abstract

The Relationship between Predominant Polarity, Lifetime Comorbid Anxiety Disorders and Subjective Quality of Life among Individuals with Bipolar Disorder in Singapore

Gunasekaran

Teh

Liu

et al. 2023

IJERPH

View full text Add to dashboard Cite

Background: Depressive features and comorbid anxiety disorders are two discrete but interconnected clinical features that have been reported to be associated with a poorer quality of life (QoL) among individuals with bipolar disorders. However, the relationship between manic features and quality of life is less conclusive. The present study aimed to assess differences in QoL among bipolar outpatients who present with either depressive predominant polarity (DPP), manic predominant polarity (MPP) and/or a lifetime diagnosis of comorbid anxiety disorders in Singapore. Methods: Data from 74 outpatients in Singapore diagnosed with bipolar disorder were collected. Sociodemographic information, the polarity of most episodes (2 out of 3), the diagnosis of anxiety disorders and QoL were obtained from a self-reported interview and/or through clinical records. QoL was measured using the abbreviated version of the World Health Organization questionnaire. We used multivariate regression models to determine the relationships between predominant polarity, lifetime comorbid anxiety disorders and QoL in physical health, psychological health, social relationships and environment domains. Results: After adjusting for covariates, individuals with DPP scored poorer for WHOQOL-BREF for all four domains as compared with individuals with indeterminate polarity. As compared to individuals with indeterminate polarity, individuals with MPP scored poorer for WHOQOL-BREF social relationships. Lastly, individuals with lifetime comorbid anxiety disorders scored poorer for WHOQOL-BREF physical health, social relationships and environment. Discussion and Conclusions: The present study provides preliminary support for the relationship between DPP, lifetime comorbid anxiety disorders and poorer QoL, paving the pathway for future research with larger samples to utilise our study design to verify our results.

show abstract

Epidemiological and clinical variables related with the predominant polarity on bipolar disorder: A systematic review

Cited by 3 publications

References 48 publications

The Mixed Tendency in Bipolar Disorder: An Operational Proposal for the Integration of Mixed Episodes in Predominant Polarity

The Mixed Tendency in Bipolar Disorder: An Operational Proposal for the Integration of Mixed Episodes in Predominant Polarity

Features Associated With Depressive Predominant Polarity and Early Illness Onset in Patients With Bipolar Disorder

The Relationship between Predominant Polarity, Lifetime Comorbid Anxiety Disorders and Subjective Quality of Life among Individuals with Bipolar Disorder in Singapore

Contact Info

Product

Resources

About