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Bipolar II illness: course and outcome over a five-year period

Published online by Cambridge University Press:  09 July 2009

William Coryell ,
Martin Keller ,
Jean Endicott ,
Nancy Andreasen ,
Paula Clayton  and
Robert Hirschfeld
William Coryell*
Affiliation:
National Institute of Mental Health Collaborative Program on the Psychobiology of Depression–Clinical Studies, University of Iowa, USA
Martin Keller
Affiliation:
National Institute of Mental Health Collaborative Program on the Psychobiology of Depression–Clinical Studies, University of Iowa, USA
Jean Endicott
Affiliation:
National Institute of Mental Health Collaborative Program on the Psychobiology of Depression–Clinical Studies, University of Iowa, USA
Nancy Andreasen
Affiliation:
National Institute of Mental Health Collaborative Program on the Psychobiology of Depression–Clinical Studies, University of Iowa, USA
Paula Clayton
Affiliation:
National Institute of Mental Health Collaborative Program on the Psychobiology of Depression–Clinical Studies, University of Iowa, USA
Robert Hirschfeld
Affiliation:
National Institute of Mental Health Collaborative Program on the Psychobiology of Depression–Clinical Studies, University of Iowa, USA
*
1Address for correspondence: Dr William Coryell, University of Iowa, Department of Psychiatry, 500 Newton Road, Iowa City, 1A 52242, USA.
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Synopsis

A five year semi-annual follow-up of patients with non-bipolar (N = 442), bipolar II (N = 64) and bipolar I (N = 53) major depression tracked the courses of prospectively observed major depressive, hypomanic and manic syndromes. In all three groups, depression was much more likely in any given week than was hypomania or mania. However, during the majority of weeks, no full syndrome was present and none of the groups exhibited evidence of continuing psychosocial deterioration. Though all three groups exhibited similar times to recovery from index and subsequent major depressive episodes, both bipolar groups had substantially higher relapse rates and developed more episodes of major depression, hypomania and mania. The two bipolar groups, in turn, differed by the severity of manic-like syndromes and thus remained diagnostically stable; the bipolar II patients were much less likely to develop full manic syndromes or to be hospitalized during follow-up. In conjunction with family study data showing that bipolar II disorder breeds true, these data support the separation of bipolar I and bipolar II affective disorder.

Type
Research Article
Information
Psychological Medicine , Volume 19 , Issue 1 , February 1989 , pp. 129 - 141
Copyright
Copyright © Cambridge University Press 1989

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References

Andreasen, N. C., Grove, W. M., Endicott, J., Coryell, W. H., Scheftner, W. A., Hirschfeld, R. M. A. & Keller, M. B. (1988) The phenomenology of depression. Psychiatrv and Psychobtology 3, 1–10.CrossRefGoogle Scholar
Angst, J. (1986). The course of major depression, atypical bipolar disorder, and bipolar disorder. In New Results in Depression Research (ed. Hippius, H.), pp. 26–35. Springer-Verlag: Berlin.CrossRefGoogle Scholar
Ayuso-Gutierrez, J. L. & Ramos-Brieda, J. A. (1982). The course of manic depressive illness. Journal of Affective Disorders 4, 9–14.CrossRefGoogle ScholarPubMed
Coryell, W. & Winokur, G. (1982). Course and outcome. In Handbook of Affective Disorders, (ed. Paykel, E. S.), pp. 93–106. Churchill Livingston: London.Google Scholar
Coryell, W., Endicott, J., Reich, T., Andreasen, N. & Keller, M. (1984 a). A family study of bipolar II disorder. British Journal of Psychiatry 145, 49–54CrossRefGoogle ScholarPubMed
Coryell, W., Lavori, P., Endicott, J., Keller, M. & VanEerdewegh, M. (1984 b). Outcome in schizo-affective, psychotic and nonpsychotic depression. Archives of General Psychiatry 41, 787–791.CrossRefGoogle Scholar
Coryell, W., Andreasen, N., Endicott, J. & Keller, M. (1987). The significance of past mania or hypomania in the course and outcome of major depression. American Journal of Psychiatry 144, 309–315.Google ScholarPubMed
Endicott, J & Spitzer, R. L. (1978). A diagnostic interview: the Schedule for Affective Disorders and Schizophrenia. Archives of General Psychiatry 35, 837–844.CrossRefGoogle ScholarPubMed
Endicott, J., Spitzer, R. J., Fleiss, J. L. & Cohen, J. (1976). The Global Assessment Scale: a procedure for measuring overall severity of psychiatric disturbance. Archives of General Psychiatry 33, 766–771.CrossRefGoogle Scholar
Endicott, J., Nee, JAndreasen, N., Clayton, P., Keller, M. & Coryell, W. (1985). Bipolar II: combine or keep separate? Journal of Affective Disorders 8, 17–28.CrossRefGoogle ScholarPubMed
Kalbfleisch, J. D. & Prentice, R. L. (1980). The Statistical Analysis of Failure Time Data, pp. 12–15. Wiley and Sons: New York.Google Scholar
Keller, M. B., Lavori, P. W., Endicott, J., Coryell, W. & Klerman, G. (1983). Double depression: two year follow-up. American Journal of Psychiatry 140, 689–694.Google ScholarPubMed
Keller, M. B., Lavori, P. W., Coryell, W., Andreasen, N., Endicott, J., Clayton, P., Klerman, G. & Hirschfeld, R. M. A. (1986). Differential outcome of pure manic, mixed/cycling, and pure depressive episodes in patients with bipolar illness. Journal of the American Medical Association 255, 3138–3142.CrossRefGoogle ScholarPubMed
Keller, M. B., Lavori, P. W., Friedman, B., Neilsen, E., Endicott, J., McDonald-Scott, P. & Andreasen, N. (1987). The longitudinal interval follow-up evaluation. Archives of General Psychiatry 44, 540–548.CrossRefGoogle ScholarPubMed
Kukopulos, A., Reginaldi, D., Laddomada, P., Floris, G., Serra, G., & Tondo, L. (1980). Course of the manic depressive cycle and changes caused by treatments. Pharmakopsychiatrie Neuro-psychopharmakologie 13, 156–167.CrossRefGoogle Scholar
MacDonald, M J. (1974). Equal incidence of adult-onset diabetes among ancestors of juvenile diabetics and nondiabetics. Diabetologia 10, 767–773.CrossRefGoogle Scholar
Spitzer, R. L., Endicott, J. & Robins, E. (1978). Research Diagnostic Criteria (third edn). Biometrics Research, New York State Department of Mental Hygeine: New York, NY.CrossRefGoogle ScholarPubMed
Welner, A., Welner, Z. & Leonard, M. A. (1977). Bipolar manic depressive disorder: a re-assessment of course and outcome. Comprehensive Psychiatry 18, 327–332.CrossRefGoogle Scholar
Winer, B. J. (1971). Statistical Principles in Experimental Design (second edn), p. 198. McGraw-Hill: New York.Google Scholar