Clinical characteristic of prodromal symptoms between bipolar I and II disorder among Chinese patients: a retrospective study.
Bipolar I disorder
Bipolar II disorder
Depression
Early recognition
Mania
Prodromal symptoms
Journal
BMC psychiatry
ISSN: 1471-244X
Titre abrégé: BMC Psychiatry
Pays: England
ID NLM: 100968559
Informations de publication
Date de publication:
31 05 2021
31 05 2021
Historique:
received:
02
02
2021
accepted:
11
05
2021
entrez:
1
6
2021
pubmed:
2
6
2021
medline:
29
6
2021
Statut:
epublish
Résumé
This study aimed to identify the clinical characteristic of prodromal symptoms in Chinese patients with bipolar disorder (BD), prior to the first affective episode. It further aimed to characterize the prodromal traits between bipolar disorder type I (BD-I) and type II (BD-II). 120 individuals with BD-I (n = 92) and BD- II (n = 28) were recruited to the study. Semi-structured interviews were then administered to evaluate prodromal symptoms in patients, within 3 years of BD onset, by using the Bipolar Prodrome Symptom Scale-Retrospective (BPSS-R). In the prodromal phase of the first depressive episode, patients with BD-II experienced more prodromal symptoms (p = 0.0028) compared to BD-I. Additionally, more frequent predictors were reported in patients with BD-II than BD-I including educational and occupational dysfunction (p = 0.0023), social isolation (p < 0.001), difficulty making decisions (p = 0.0012), oppositionality (p = 0.012), and suspiciousness/persecutory ideas (p = 0.017). There were also differences in the duration of the precursors. The duration of "weight loss or decrease in appetite" (p = 0.016) lasted longer in patients with BD-I, while "obsessions and compulsions" (p = 0.023) started earlier in patients with BD-II and occurred during the pre-depressive period. The prevalence and duration of each reported prodrome, preceding a first (hypo) manic episode, showed no difference between patients with BD-I and BD-II. Specific affective, general, or psychotic symptoms occurred prior to both affective episodes. The characteristic of prodromal symptoms were key predictors for later episodes of BD including attenuated mania-like symptoms, subthreshold depressed mood, mood swings/lability, and anxiety. In the pre-depressive state, when compared to BD-II, BD-I presented with more prodromal symptoms in nonspecific dimensions, which indicated the substantial burden of BD-II. In conclusion, this study extends the understanding of the characteristics of prodromes of BD-I and BD-II.
Sections du résumé
BACKGROUND
This study aimed to identify the clinical characteristic of prodromal symptoms in Chinese patients with bipolar disorder (BD), prior to the first affective episode. It further aimed to characterize the prodromal traits between bipolar disorder type I (BD-I) and type II (BD-II).
METHODS
120 individuals with BD-I (n = 92) and BD- II (n = 28) were recruited to the study. Semi-structured interviews were then administered to evaluate prodromal symptoms in patients, within 3 years of BD onset, by using the Bipolar Prodrome Symptom Scale-Retrospective (BPSS-R).
RESULTS
In the prodromal phase of the first depressive episode, patients with BD-II experienced more prodromal symptoms (p = 0.0028) compared to BD-I. Additionally, more frequent predictors were reported in patients with BD-II than BD-I including educational and occupational dysfunction (p = 0.0023), social isolation (p < 0.001), difficulty making decisions (p = 0.0012), oppositionality (p = 0.012), and suspiciousness/persecutory ideas (p = 0.017). There were also differences in the duration of the precursors. The duration of "weight loss or decrease in appetite" (p = 0.016) lasted longer in patients with BD-I, while "obsessions and compulsions" (p = 0.023) started earlier in patients with BD-II and occurred during the pre-depressive period. The prevalence and duration of each reported prodrome, preceding a first (hypo) manic episode, showed no difference between patients with BD-I and BD-II.
CONCLUSIONS
Specific affective, general, or psychotic symptoms occurred prior to both affective episodes. The characteristic of prodromal symptoms were key predictors for later episodes of BD including attenuated mania-like symptoms, subthreshold depressed mood, mood swings/lability, and anxiety. In the pre-depressive state, when compared to BD-II, BD-I presented with more prodromal symptoms in nonspecific dimensions, which indicated the substantial burden of BD-II. In conclusion, this study extends the understanding of the characteristics of prodromes of BD-I and BD-II.
Identifiants
pubmed: 34059028
doi: 10.1186/s12888-021-03295-y
pii: 10.1186/s12888-021-03295-y
pmc: PMC8168043
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
275Références
J Affect Disord. 2015 Dec 1;188:257-62
pubmed: 26378735
J Affect Disord. 2015 Mar 1;173:39-44
pubmed: 25462394
Braz J Psychiatry. 2015 Apr-Jun;37(2):121-5
pubmed: 26018648
J Affect Disord. 2013 Sep 5;150(2):363-9
pubmed: 23707033
Bipolar Disord. 2010 Aug;12(5):494-503
pubmed: 20712750
J Neurol Neurosurg Psychiatry. 1960 Feb;23:56-62
pubmed: 14399272
J Affect Disord. 2017 Apr 01;212:86-92
pubmed: 28157551
J Affect Disord. 2010 Feb;121(1-2):143-6
pubmed: 19560827
Acta Psychiatr Scand. 2017 Aug;136(2):201-209
pubmed: 28542780
Psychol Med. 2006 May;36(5):619-27
pubmed: 16438739
Acta Psychiatr Scand. 2010 Sep;122(3):255-66
pubmed: 20199490
Schizophr Bull. 2015 Sep;41(5):1076-83
pubmed: 25512596
Bipolar Disord. 2014 Mar;16(2):180-9
pubmed: 24215495
Acta Psychiatr Scand. 2017 Apr;135(4):273-284
pubmed: 28097648
Schizophr Bull. 2007 May;33(3):703-14
pubmed: 17478437
J Affect Disord. 2016 Jan 15;190:26-33
pubmed: 26480208
Bipolar Disord. 2004 Aug;6(4):305-13
pubmed: 15225148
Lancet Psychiatry. 2019 Mar;6(3):211-224
pubmed: 30792114
J Affect Disord. 2003 Jan;73(1-2):19-32
pubmed: 12507734
Eur Arch Psychiatry Clin Neurosci. 1998;248(5):240-4
pubmed: 9840370
Expert Rev Neurother. 2013 Jan;13(1):89-98
pubmed: 23253393
Acta Psychiatr Scand. 2014 Apr;129(4):275-85
pubmed: 23837831
Am J Psychiatry. 2018 May 1;175(5):411-426
pubmed: 29361850
Br J Psychiatry. 1988 May;152:660-4
pubmed: 3167442
Bipolar Disord. 2014 Aug;16(5):478-92
pubmed: 24597782
Lancet Psychiatry. 2018 Nov;5(11):930-939
pubmed: 30146246
Br J Psychiatry. 1978 Nov;133:429-35
pubmed: 728692
J Affect Disord. 2013 Nov;151(2):551-560
pubmed: 23932736
Lancet. 2016 Apr 9;387(10027):1561-1572
pubmed: 26388529
Int J Neuropsychopharmacol. 2003 Jun;6(2):127-37
pubmed: 12890306
J Affect Disord. 2015 Sep 01;183:45-8
pubmed: 26001662
JAMA Psychiatry. 2017 Aug 1;74(8):841-847
pubmed: 28678992
Bipolar Disord. 2020 Jun;22(4):392-400
pubmed: 31724302
J Affect Disord. 2012 Jan;136(1-2):1-8
pubmed: 21943929
Am J Psychiatry. 2016 Jul 1;173(7):695-704
pubmed: 26892940
Bipolar Disord. 2000 Sep;2(3 Pt 2):281-93
pubmed: 11249806
PLoS One. 2014 Sep 26;9(9):e106871
pubmed: 25259889
Expert Rev Neurother. 2017 Mar;17(3):277-285
pubmed: 27659841
Lancet. 2013 May 11;381(9878):1663-71
pubmed: 23663952
J Am Acad Child Adolesc Psychiatry. 2016 Jul;55(7):543-55
pubmed: 27343882
J Psychiatr Res. 2016 Oct;81:63-70
pubmed: 27392070
J Clin Psychiatry. 2010 Mar;71(3):255-61
pubmed: 19709503
Bipolar Disord. 2014 Aug;16(5):471-7
pubmed: 23782499
Am J Psychiatry. 2015 Jul;172(7):638-46
pubmed: 25734353
Bipolar Disord. 2017 Aug;19(5):363-374
pubmed: 28691361
J Affect Disord. 2010 Dec;127(1-3):316-20
pubmed: 20619465