Bipolar Disorders: Mixed States, Rapid-Cycling, and Atypical Forms

Table 5.2 Bipolar II (BP-II), minimum bipolar (MinBP), and major depressive disorder (MDD) subclassified by presence of recurrent brief depression(RBD)1 2 3 4 5 6 7 8 1–7BP-II RBD BP-II MDD RBD MDD MinBP RBD MinBP RBD pure Controls(n ¼ 39) (n ¼ 50) (n ¼ 39) (n ¼ 62) (n ¼ 42) (n ¼ 17) (n ¼ 60) (n ¼ 138)(%) (%) (%) (%) (%) (%) (%) (%)Prevalence rates (age 20–41 years) 4.3 6.7 3.5 7.9 6.0 3.4 7.5 42.4Females 59.6 57.7 87.9 57.9 54.0 67.9 53.2 42.5 0.4804RBMRBM threshold (RBM) 20.5 20.0 21.4 5.9 NCRBMS subthreshold þ RBM 35.9 34.0 33.3 17.7 NCCyclothymia (>49% days/1 year) 14.3 23.5 NCRecurrent brief anxiety 59.0 32.0 43.6 17.7 40.5 11.8 43.3 4.9 0.0003Family history (FH)FH þ depression 71.8 50.0 74.4 57.9 68.3 64.7 55.8 30.0 0.0373FH þ mania 20.5 10.4 2.9 4.0 10.0 11.8 4.4 4.2 0.0001FH þ anxiety 48.7 34.0 48.7 19.3 43.9 23.5 34.6 15.4 0.0001Clinical consequencesSuicide attempts 38.5 16.0 25.6 22.6 7.1 4.9 11.7 2.7 0.0001Subjective or social consequences of hypomania 53.9 48.0 40.5 29.4 NCConsequences of hypomania or depression 64.1 55.1 61.1 42.9 47.6 47.1 36.0Lifetime treatment of depression 82.5 60.0 69.2 50.0 66.7 52.9 46.7 0.0078Work impairment 100 82.0 100 89.9 100 82.4 100 NCMaximum distress depression (mean) 86.9 80.6 85.1 83.3 81.3 81.7 77.4 0.1717Onset and courseAge of onset (mean) (years) 12.0 13.3 12.3 15.3 12.6 14.4 16.1 0.0002Age of first treatment (mean) (years) 21.7 22.8 22.0 23.4 23.2 22.3 22.6 0.0002CourseRecurrent 100 95.2 81.8 90.9 100 90 100 NCP