The authors of this paper do not have any commercial associations that might pose a conflict of interest in connection with this manuscript.
Three times more days depressed than manic or hypomanic in both bipolar I and bipolar II disorder1
Article first published online: 2 AUG 2007
Volume 9, Issue 5, pages 531–535, August 2007
How to Cite
Kupka, R. W., Altshuler, L. L., Nolen, W. A., Suppes, T., Luckenbaugh, D. A., Leverich, G. S., Frye, M. A., Keck, P. E., McElroy, S. L., Grunze, H. and Post, R. M. (2007), Three times more days depressed than manic or hypomanic in both bipolar I and bipolar II disorder. Bipolar Disorders, 9: 531–535. doi: 10.1111/j.1399-5618.2007.00467.x
- Issue published online: 2 AUG 2007
- Article first published online: 2 AUG 2007
- Received 18 August 2006, revised and accepted for publication 22 December 2006
- bipolar I disorder;
- bipolar II disorder;
- course of illness
Objectives: To assess the proportion of time spent in mania, depression and euthymia in a large cohort of bipolar subjects studied longitudinally, and to investigate depression/mania ratios in patients with bipolar I versus bipolar II disorder.
Methods: Clinician-adjusted self-ratings of mood were completed daily for one year for naturalistically treated outpatients with bipolar I (n = 405) or bipolar II (n = 102) disorder. Ratings were analyzed for mean time spent euthymic, depressed, manic, hypomanic, and cycling, and the percentages of time spent ill were compared between the two groups.
Results: Percentages of time spent ill for bipolar I versus II patients were: euthymia 47.7% versus 50.2%; depression 36.0% versus 37.0%; hypomania 11.5% versus 9.8%; mania 1.0% versus 0.2%; and cycling 3.7% versus 2.8%. The depression/mania ratio was 2.9 in the bipolar I and 3.8 in bipolar II sub-groups.
Conclusions: Depression represents the predominant abnormal mood state for treated outpatients with bipolar I and II disorder. In contrast to other studies, we found that depression/mania ratios were of a similar magnitude, suggesting the same tendency towards mood instability in both sub-groups.