Impact of depressive mixed state in an emergency psychiatry setting: A marker of bipolar disorder and a possible risk factor for emergency hospitalization

Rate and predictors of conversion from unipolar to bipolar disorder: A systematic review and meta‐analysis

“…For example, it is a widely held belief that a family history of bipolar disorder increases the risk of conversion from unipolar disorder to bipolar disorder. However, only two out of four studies using survival analysis and only three out of five studies not using survival analysis found a statistically significant association between family history of bipolar disorder and conversion to bipolar disorder. Similarly, young age at first depression is often claimed to increase the risk of conversion, but the present systematic review shows that studies confirming such an association are not more frequent than those not confirming it; younger age at onset was found to be associated with conversion in four out of seven studies using survival analysis and five out of eight onset studies not using survival analysis.…”

“…Compared to conversion risks in studies with prospective assessments, conversions risks were higher in the five studies with retrospective assessment only: 10.1% within 1 year of follow‐up in the only study using survival analysis (Table ) and, in studies not using survival analysis (Table ), 32.8% during a mean of 18.5 years of follow‐up, 18.9% in 1 year, 30.2% during a median follow‐up period of 189 days, and 35.5% during a mean follow‐up period of 8.8 years …”

“…From Table , it can be seen that two out of eight studies found a statistically significant gender association with conversion, with one finding that female patients converted more frequently and one that they converted less frequently . Among eight studies investigating age at onset, five found that earlier onset was associated with a higher risk of conversion .…”

“…Among eight studies investigating age at onset, five found that earlier onset was associated with a higher risk of conversion . A total of four studies investigated number of depressive episodes, all finding that the risk of conversion increased statistically significantly with the number of depressive episodes.…”

“…From Table 4, it can be seen that two out of eight studies 5,12,14,26,29-32 found a statistically significant gender association with conversion, with one finding that female patients converted more frequently 29 and one that they converted less frequently. 32 Among eight studies investigating age at onset, 5,12,14,26,[30][31][32][33] five found that earlier onset was associated with a higher risk of conversion. 5,12,26,31,33 A total of four studies investigated number of depressive episodes, 14,28,31,33 all finding that the risk of conversion increased statistically significantly with the number of depressive episodes.…”