Hostname: page-component-848d4c4894-wg55d Total loading time: 0 Render date: 2024-06-02T01:43:48.179Z Has data issue: false hasContentIssue false
  • English
  • Français

Manic-depressive illness — I: clinical characteristics of bipolar disorder subtypes

Published online by Cambridge University Press:  13 June 2014

Patrick McKeon ,
Patrick Manley  and
Gregory Swanwick
Get access Rights & Permissions [Opens in a new window]

Abstract

The clinical and demographic features of 100 bipolar disorder patients, who were categorised into bipolar I, bipolar II, unipolar mania and rapid cycling groups, and who were further classified on the basis of the sequence of occurrence of the manic and depressive episodes within each cycle, are compared. Bipolar I (including unipolar manic) patients, 77% of whom had a sequence of moods where mania preceded depression (Mania-Depression – normothymic Interval: M.D.I.) constituted 69% of the total sample. Six per cent were classified as bipolar II and 25% has a rapid cycling disorder. Patients who had an M.D.I. sequence of moods, whether rapid or non-rapid cycling, had a younger age of onset, a higher male:female ratio and a stronger family history of bipolar disorder than patients whose depression preceded mania (D.M.I.). Unipolar manic patients, 12% of the sample, had a comparable age of onset, a greater family history of bipolarity and more frequent hospitalisations than the bipolar I-M.D.I. group. Rapid cycling patients had a lower mean serum thyroxine concentration than the non-rapid cycling bipolar disorder patients. This study supports the rationale for distinguishing bipolar patients with an M.D.I, sequence from those with a D.M.I, pattern and rapid cyclers from non-rapid cyclers.

Keywords

Bipolar affective disorderunipolar maniarapid cycling disorderclinical characteristicsthyroid function
Type
Original Papers
Information
Irish Journal of Psychological Medicine , Volume 9 , Issue 1 , May 1992 , pp. 6 - 9
Copyright
Copyright © Cambridge University Press 1992

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Dunner, DL, Fieve, RR. Clinical factors in lithium prophylaxis failure. Arch Gen Psychiatry 1974; 30: 229–233.CrossRefGoogle Scholar
2.Kukopulos, A, Reginaldi, D. Recurrences of manic-depressive episodes during lithium treatment. In: Johnson, FN, editor. Handbook of lithium therapy. Lancaster: MTP Press, 1980.Google Scholar
3.Angst, J, Felder, W, Frey, R, Stassen, HH. The course of affective disorders: I. Change of diagnosis of monopolar, unipolar and bipolar illness. Arch Psychiat Nervenkr 1978; 226.: 57–64.CrossRefGoogle ScholarPubMed
4.Kukopulos, A, Reginaldi, D. Does lithium prevent depressions by suppressing manias? Int Pharmacopsychiatry 1973; 8: 152–158.CrossRefGoogle ScholarPubMed
5.Coryell, W, Endicott, J, Reich, T, Andreasen, N, Keller, M. A family study of bipolar II disorder. Br J Psychiatry 1984; 145: 49–54.CrossRefGoogle ScholarPubMed
6.Coryell, W, Endicott, J, Andreasen, N, Keller, M. Bipolar I, bipolar II and nonbipolar major depression among the relatives of affectively ill probands. Am J Psychiatry 1985; 142: 817–821.Google ScholarPubMed
7.Endicott, J, Nee, J, Andreasen, N, Clayton, P, Keller, M, Coryell, W. Bipolar II: combine or keep separate? J Affective Disord 1985; 8: 17–28.CrossRefGoogle ScholarPubMed
8.Wehr, TA, Sack, DA, Rosenthal, NE, Chowdry, RW. Rapid cycling affective disorder: contributing factors and treatment responses in 51 patients. Am J Psychiatry 1988; 145: 179–84.Google ScholarPubMed
9.Dunner, DL, Patrick, V, Fieve, RR. Rapid cycling-manic depressive patients. Compr Psychiatry 1977; 18: 561–566.CrossRefGoogle ScholarPubMed
10.Alarcon, RD. Rapid cycling affective disorders: a clinical review. Compr Psychiatry 1985; 26: 522–540.CrossRefGoogle ScholarPubMed
11.Parr, BL. Reproductive factors affecting the course of affective illness in women. Psychiatr Clin North Am 1989; 12: 207–220.CrossRefGoogle Scholar
12.Cho, JT, Bone, S, Dunner, DL. The effect of lithium treatment on thyroid function in patients with primary affective disorder. Am J Psychiatry, 1979; 136: 115–6.Google ScholarPubMed
13.Chowdry, RW, Wehr, TA, Zis, AP, Goodwin, FK. Thyroid abnormalities associated with rapid cycling bipolar illness. Arch Gen Psychiatry 1983; 40: 414–420.CrossRefGoogle Scholar
14.Akiskal, HS. The joint use of clinical and biological criteria for psychiatric diagnosis. In: Akiskal, HS, Webb, WL, editors. Psychiatric diagnosis – exploration of biological predictors. New York: Spectru, 1978.Google Scholar
15.Coppen, A, Noguera, R, Bailey, J, Burns, BH, Swani, MS, Hare, EH, et al.Prophylactic lithium in affective disorders. Lancet 1971; ii: 275–9.CrossRefGoogle Scholar
16.Haag, H, Heidorn, A, Haag, M, Greil, W. Sequence of affective polarity and lithium response: Preliminary report on Munich sample. Prog Neuropsychopharmacol and Biol Psychiat 1987; 11: 205–208.CrossRefGoogle ScholarPubMed
17.Leonhard, K. The classification of endogenous psychoses. 5th ed. Edited by Robins, Eli. Translated by Berman, Russell. New York: Irvington Publishers, 1979. Aufteilung der Endogenen Psychosen. 1st ed. Berlin: Akademie – Verlag, 1957.Google Scholar
18.Perris, C, editor. A study of bipolar (manic-depressive) and unipolar recurrent depressive psychoses. Acta Psychiatr Scand 1966; 42 Suppl 194: 1–199.Google ScholarPubMed
19.Angst, J. The course of affective disorders. II. Typology of bipolar manic-depressive illness. Arch Psychiat Nervenkr 1978; 226: 65–73.CrossRefGoogle ScholarPubMed
20.Winokur, G, Clayton, PJ, Reich, T. Manic depressive illness. St. Louis: CV Mosby, 1969.Google Scholar
21.McKeon, P, Manley, P, Swanwick, G. Manic-depressive illness – II: treatment outcome in bipolar disorder subtypes. Ir J Psychol Med 1992; 9(1):Google Scholar
22.Sack, DA, James, SP, Rosenthal, N, Wehr, TA. Deficient nocturnal surge of TSH secretion during sleep and sleep deprivation in rapid-cycling bipolar illness. Psychiatry Res 1988; 23: 179–91.CrossRefGoogle ScholarPubMed