Document Detail

Phenomenology of rapid-cycling bipolar disorder: data from the first 500 participants in the Systematic Treatment Enhancement Program.
MedLine Citation:
PMID:  15465989     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: This study compared demographic and phenomenological variables between bipolar patients with and without rapid cycling as a function of bipolar I versus bipolar II status. METHOD: The authors examined demographic, historical, and symptomatic features of patients with and without rapid cycling in a cross-sectional study of the first 500 patients with bipolar I or bipolar II disorder enrolled in the Systematic Treatment Enhancement Program for Bipolar Disorder, a multicenter project funded by the National Institute of Mental Health designed to evaluate the longitudinal outcome of patients with bipolar disorder. RESULTS: Rapid-cycling bipolar disorder occurred in 20% of the study group. Rapid-cycling patients were more likely to be women, although the effect was somewhat more pronounced among bipolar I patients than bipolar II patients. In addition, rapid-cycling bipolar patients experienced onset of their illness at a younger age, were more often depressed at study entry, and had poorer global functioning in the year before study entry than nonrapid-cycling patients. Rapid-cycling patients also experienced a significantly greater number of depressive and hypomanic/manic episodes in the prior year. A lifetime history of psychosis did not distinguish between rapid and nonrapid-cycling patients, although bipolar I patients were more likely to have experienced psychosis than bipolar II patients. CONCLUSIONS: Patients with rapid-cycling bipolar disorder demonstrate a greater severity of illness than nonrapid-cycling patients on a number of clinical measures. This study highlights the need to refine treatments for rapid cycling to reduce the overall morbidity and mortality of patients with this illness course modifier.
Christopher D Schneck; David J Miklowitz; Joseph R Calabrese; Michael H Allen; Marshall R Thomas; Stephen R Wisniewski; Sachiko Miyahara; Melvin D Shelton; Terence A Ketter; Joseph F Goldberg; Charles L Bowden; Gary S Sachs
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Publication Detail:
Type:  Comparative Study; Journal Article; Multicenter Study; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  The American journal of psychiatry     Volume:  161     ISSN:  0002-953X     ISO Abbreviation:  Am J Psychiatry     Publication Date:  2004 Oct 
Date Detail:
Created Date:  2004-10-06     Completed Date:  2004-11-16     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  0370512     Medline TA:  Am J Psychiatry     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1902-8     Citation Subset:  AIM; IM    
Department of Psychiatry, University of Colorado Health Sciences Center, 4455 East 12th Ave., Box A011-15, Denver, CO 80220, USA.
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MeSH Terms
Age of Onset
Bipolar Disorder / diagnosis*,  epidemiology,  psychology*
Cohort Studies
Cross-Sectional Studies
Depressive Disorder / diagnosis,  epidemiology,  psychology
Diagnosis, Differential
Diagnosis, Dual (Psychiatry)
Psychiatric Status Rating Scales
Severity of Illness Index
Sex Factors
Substance-Related Disorders / diagnosis,  epidemiology,  psychology
Grant Support
Comment In:
Evid Based Ment Health. 2005 May;8(2):52   [PMID:  15851815 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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