Predominant polarity in bipolar disorder: Diagnostic implications

Rosa, Adriane Ribeiro; Andreazza, Ana Cristina; Kunz, Maurício; Gomes, Fabiano A.; Santin, Ana Paula; Sanchez-Moreno, José; Reinares, María; Colom, Francesc; Vieta, Eduard; Kapczinski, Flávio

doi:10.1016/j.jad.2007.07.021

Cited by 91 publications

(74 citation statements)

References 39 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Main differences, probably due to a larger study sample, involved gender, history of psychotic symptoms, substance use preceding first episode and seasonal pattern. Other findings were consistent, as expected with data from our group (35,39), but also from independent samples from other areas, countries, and continents (15,38,40,41). An issue raised during this research is whether it was the PP to determine the different prescribing pattern.…”

Section: Discussionsupporting

confidence: 91%

See 1 more Smart Citation

Clinical implications of predominant polarity and the polarity index in bipolar disorder: a naturalistic study

Popović

Torrent

Goikolea

et al. 2013

Acta Psychiatr Scand

Self Cite

View full text Add to dashboard Cite

Clinical implications of predominant polarity and the polarity index in bipolar disorder: a naturalistic study.Objective: Predominant polarity (PP) is an important variable in maintenance treatment of bipolar disorder (BD). This study aimed at determining the role of polarity index (PI), a metric indicating antimanic versus antidepressive prophylactic potential of drugs, in clinical decision-making. Method: Two hundred and fifty-seven of 604 (43%) of patients with BD-I or II fulfilled criteria for manic (MPP) or depressive PP (DPP). The PI, representing the ratio of number needed to treat (NNT) for depression prevention to NNT for mania prevention, was calculated for patients' current treatment. MPP and DPP groups were compared regarding sociodemographic, clinical and therapeutic characteristics. Results: One hundred and forty-three patients (55.6%) fulfilled criteria for DPP and 114 (44.4%) for MPP. Total PI, Antipsychotics' PI, and mood stabilizers PI were higher, indicating a stronger antimanic action, in MPP. MPP presented higher prevalence of BD-I, male gender, younger age, age at onset and at first hospitalization, more hospitalizations, primary substance misuse, and psychotic symptoms. DP correlated with BD-II, depressive onset, primary life events, melancholia, and suicide attempts. Conclusion:The results confirm the usefulness of the PI. In this large sample, clinical differences among these groups justify differential treatment approach. The PI appears to be a useful operationalization of what clinicians do for maintenance therapy in BD.

show abstract

Section: Discussionsupporting

confidence: 91%

“…Around one-half of patients were reported to present predominant polarity (12,13), and various studies have detected clinical differences between predominantly manic and predominantly depressed patients (7,12,14,15).…”

Section: Introductionmentioning

confidence: 99%

Clinical implications of predominant polarity and the polarity index in bipolar disorder: a naturalistic study

Popović

Torrent

Goikolea

et al. 2013

Acta Psychiatr Scand

Self Cite

View full text Add to dashboard Cite

show abstract

“…[24][25][26] According to that theory, some patients tend to have twice or more manic than depressive episodes, whereas the opposite is true for some other patients. Such type of predominance seems to be found in about half of the patients with BD.…”

Section: Resultsmentioning

confidence: 99%

“…24 Still according to that theory, the predominance of depressive episodes is more frequent than that of manic episodes 25,26 and is be associated with poorer outcomes. [24][25][26] Differently from other studies, we did not find any correlation between outcome and psychotic symptoms 4,15,16,[27][28][29][30] or number of previous hospitalizations. 31,32 However, contradictions about which factors predict outcomes are frequent in the literature.…”

Section: Resultsmentioning

confidence: 99%

The progression of 102 Brazilian patients with bipolar disorder: outcome of first 12 months of prospective follow-up

Novis

Cirillo

Silva

et al. 2014

Trends Psychiatry Psychother.

View full text Add to dashboard Cite

Introduction: Prospective studies have shown that the course of bipolar disorder (BD) is characterized by the persistence of symptoms, predominantly depression, along most of the time. However, to our knowledge, no studies in Latin America have investigated it. Objectives: To replicate international studies using a Brazilian sample to prospectively analyze treatment outcomes in the first year and to determine potential chronicity factors. Methods: We followed up 102 patients with BD for 12 months and evaluated the number of months with affective episodes and the intensity of manic and depressive symptoms using the Young Mania Rating Scale (YMRS) and the Hamilton Depression Scale (HAM-D17). Sociodemographic and retrospective clinical data were examined to determine possible predictors of outcome. Results: Almost 50% of the patients had symptoms about half of the time, and there was a predominance of depressive episodes. Disease duration and number of depressive episodes were predictors of chronicity. Depressive polarity of the first episode and a higher number of depressive episodes predicted the occurrence of new depressive episodes. Conclusion: In general, BD outcome seems to be poor in the first year of monitoring, despite adequate treatment. There is a predominance of depressive symptoms, and previous depressive episodes are a predictor of new depressive episodes and worse outcome.

show abstract

“…In BD patients, it has been found an association with impulsivity, impaired decision-making, psychiatric comorbidities, predominance of depressive polarity, delay in performing diagnosis, early illness onset, childhood adversity and a previous suicide attempt [111][112][113][114][115][116][117][118]. It is often hard for clinicians to identify suicidal patients precisely, even knowing well-established risk factors for suicide, because the majority of patients with these characteristics never will kill themselves.…”

Section: Genetic Criteriamentioning

confidence: 99%

Correlation between Bipolar Affective Disorder and Suicide reviewing by the risk factors: a systematic review

Souza¹,

Ferreira²,

Oliveira³

et al. 2015

Int Arch Med

View full text Add to dashboard Cite

Background: Because there are several reports associations between affective (AD) and bipolar disorder (BD) and suicide, the research develops a discussion of risk factors that influence the occurrence of suicide attempts in patients with BD. Objectives:To relate risk factors present in patients with bipolar disorder who committed suicide or some suicide attempt. Methods:A survey was made in Scopus with the keyword "bipolar" and the terms "suicide" and "attempted"and "risk factors" from Medical Subject Headings (MeSH). We use only Scopus as the data source, and the statistical information available in tables and graphs provided from this source. Results:Frequently the AD and BD were associated with suicide occurrence in the studies included in this review. They identified the main risk factors for suicide the previous suicide attempt and hopelessness. The main risk factors for nonfatal suicidal behavior included family history of suicide, early onset of bipolar disorder, extent of depressive symptoms, increasing severity of affective episodes, the presence of mixed affective states, rapid cycling, comorbid Axis I disorders, and abuse of alcohol or drugs. The suicide rate in this disorder reaches three times compared with other mental illnesses, and there are several risk factors: 3:1 ratio of suicide in men compared to women, but in females a greater number of attempts are observed. 25% of persons consume alcohol prior to suicidal attempt. The studies relate these factors and show how they can pose a risk to the carrier of the disorder. There are other risk factor for BD discussed on this review. IntroductionBipolar affective disorder (BD) is characterized by episodes of depression and hypomania and / or mania. BD has been responsible for the higher rate of suicidal behavior compared to any other mental disorder [1,2]. It is a potentially lethal disease with a high risk of suicide completed, which again is associated with a history of suicide attempts [2]. During life, about 61% of patients with BD experiencing suicidal ideation, 25% to 56% will attempt suicide, and between 10% and 19% die from suicide2. Several studies suggest that previous suicide attempts of bipolar patients may indicate that they are over than 50% more likely to complete suicide [2]. A better understanding of the characteristics and risk factors related to suicide attempts is the first step to prevent future attempts and early detection of risk patients [1,2].Suicide is a tragic potential outcome for patients with bipolar disorder, and unfortunately, this event is not uncommon. Twenty-five percent to 50% of all bipolar patients have been found to attempt suicide at leart once in their lifetime, with 11% to 19% of bipolar patients eventually dying of suicide and standardized mortality ratio for suicide of 12.3 [3-7].There is evidence that suicide rates among mood disorder patients are more than 20-fold higher than in the general population and that suicidal behavior is much more lethal in bipolar disorder than in the general populati...

show abstract

Predominant polarity in bipolar disorder: Diagnostic implications

Cited by 91 publications

References 39 publications

Clinical implications of predominant polarity and the polarity index in bipolar disorder: a naturalistic study

Clinical implications of predominant polarity and the polarity index in bipolar disorder: a naturalistic study

The progression of 102 Brazilian patients with bipolar disorder: outcome of first 12 months of prospective follow-up

Correlation between Bipolar Affective Disorder and Suicide reviewing by the risk factors: a systematic review

Contact Info

Product

Resources

About