TY - JOUR
T1 - Onset polarity in bipolar disorder
T2 - A strong association between first depressive episode and suicide attempts
AU - Cremaschi, Laura
AU - Dell'Osso, Bernardo
AU - Vismara, Matteo
AU - Dobrea, Cristina
AU - Buoli, Massimiliano
AU - Ketter, Terence A.
AU - Altamura, A. Carlo
PY - 2017/2/1
Y1 - 2017/2/1
N2 - Background The role of onset polarity (OP) in patients with bipolar disorder (BD) has been increasingly investigated over the last few years, for its clinical, prognostic, and therapeutic implications. The present study sought to assess whether OP was associated with specific correlates, in particular with a differential suicidal risk in BD patients. Methods A sample of 362 recovered BD patients was dichotomized by OP: depressed (DO) or elevated onset (EO: hypomanic/manic/mixed). Socio-demographic and clinical variables were compared between the subgroups. Additionally, binary logistic regression was performed to assess features associated with OP. Results DO compared with EO patients had older current age and were more often female, but less often single and unemployed. Clinically, DO versus EO had a more than doubled rate of suicide attempts, as well as significantly higher rates of BD II diagnosis, lifetime stressful events, current psychotropics and antidepressants use, longer duration of the most recent episode (more often depressive), but lower rates of psychosis and involuntary commitments. Limitations Retrospective design limiting the accurate assessment of total number of prior episodes of each polarity. Conclusions Our results support the influence of OP on BD course and outcome. Moreover, in light of the relationship between DO and a higher rate of suicide attempts, further investigation may help clinicians in identifying patients at higher risk of suicide attempts.
AB - Background The role of onset polarity (OP) in patients with bipolar disorder (BD) has been increasingly investigated over the last few years, for its clinical, prognostic, and therapeutic implications. The present study sought to assess whether OP was associated with specific correlates, in particular with a differential suicidal risk in BD patients. Methods A sample of 362 recovered BD patients was dichotomized by OP: depressed (DO) or elevated onset (EO: hypomanic/manic/mixed). Socio-demographic and clinical variables were compared between the subgroups. Additionally, binary logistic regression was performed to assess features associated with OP. Results DO compared with EO patients had older current age and were more often female, but less often single and unemployed. Clinically, DO versus EO had a more than doubled rate of suicide attempts, as well as significantly higher rates of BD II diagnosis, lifetime stressful events, current psychotropics and antidepressants use, longer duration of the most recent episode (more often depressive), but lower rates of psychosis and involuntary commitments. Limitations Retrospective design limiting the accurate assessment of total number of prior episodes of each polarity. Conclusions Our results support the influence of OP on BD course and outcome. Moreover, in light of the relationship between DO and a higher rate of suicide attempts, further investigation may help clinicians in identifying patients at higher risk of suicide attempts.
KW - Bipolar disorder (BD)
KW - Onset polarity (OP)
KW - Suicide attempt
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U2 - 10.1016/j.jad.2016.11.043
DO - 10.1016/j.jad.2016.11.043
M3 - Article
AN - SCOPUS:85003020020
VL - 209
SP - 182
EP - 187
JO - Journal of Affective Disorders
JF - Journal of Affective Disorders
SN - 0165-0327
ER -