Laura Cremaschi1, Bernardo Dell'Osso2, Matteo Vismara1, Cristina Dobrea1, Massimiliano Buoli1, Terence A Ketter3, A Carlo Altamura1. 1. Department of Psychiatry, University of Milan, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy. 2. Department of Psychiatry, University of Milan, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy; Department of Psychiatry and Behavioral Sciences, Bipolar Disorders Clinic, Stanford University, CA, USA. Electronic address: bernardo.dellosso@unimi.it. 3. Department of Psychiatry and Behavioral Sciences, Bipolar Disorders Clinic, Stanford University, CA, USA.
Abstract
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.
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.
Authors: Massimiliano Buoli; Bruno Mario Cesana; Simone Bolognesi; Andrea Fagiolini; Umberto Albert; Gabriele Di Salvo; Giuseppe Maina; Andrea de Bartolomeis; Maurizio Pompili; Claudia Palumbo; Emi Bondi; Luca Steardo; Pasquale De Fazio; Mario Amore; Mario Altamura; Antonello Bellomo; Alessandro Bertolino; Marco Di Nicola; Guido Di Sciascio; Andrea Fiorillo; Emilio Sacchetti; Gabriele Sani; Alberto Siracusano; Giorgio Di Lorenzo; Alfonso Tortorella; A Carlo Altamura; Bernardo Dell'Osso Journal: Eur Arch Psychiatry Clin Neurosci Date: 2021-10-15 Impact factor: 5.270
Authors: Vincenzo Oliva; Michele De Prisco; Maria Teresa Pons-Cabrera; Pablo Guzmán; Gerard Anmella; Diego Hidalgo-Mazzei; Iria Grande; Giuseppe Fanelli; Chiara Fabbri; Alessandro Serretti; Michele Fornaro; Felice Iasevoli; Andrea de Bartolomeis; Andrea Murru; Eduard Vieta; Giovanna Fico Journal: J Clin Med Date: 2022-07-06 Impact factor: 4.964