Putative early manifestations of bipolar II disorder emerge later in the initial prodrome than manifestations hypothesized to be unrelated: an exploratory study


  • Dag V. Skjelstad,

    Corresponding author
    1. Vestre Viken Hospital Trust, Lier
    2. Norwegian Research Network on Mood Disorders (NORMOOD)
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  • Arne Holte,

    1. Norwegian Institute of Public Health, Division of Mental Health
    2. Department of Psychology, University of Oslo
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  • Ulrik F. Malt

    1. Norwegian Research Network on Mood Disorders (NORMOOD)
    2. Department of Neuropsychiatry and Psychosomatic Medicine, Oslo University Hospital
    3. University of Oslo, Institute of Clinical Medicine, Oslo, Norway
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Mr Dag V. Skjelstad, Vestre Viken Hospital Trust, Division of Mental Health and Addiction, Department of Mental Health Research and Development, P.O. Box 135,No 3401 Lier, Norway. Email: dag.skjelstad@vestreviken.no; dagskjelstad@hotmail.com


Aim: Symptom instances characterized as episodic or chronic, and as exaggerated responses to life events or inexplicable (e.g. mood swings, irritability/aggressiveness), may be the most likely early manifestations of the first episode of bipolar II disorder (BD-II). Assuming that symptoms that emerge late in the prodrome, to a larger extent, are early manifestations of the disorder itself, we explore the time of onset and the duration of instances classified as ‘likely’, ‘possible’ and ‘unlikely’ early manifestations.

Methods: Retrospective interviews of 15 BD-II patients and 22 family members.

Results: ‘Likely’ early manifestations do, to a larger extent than other symptom instances, emerge late in the prodrome. The mean time interval between symptom onset and the first episode is shorter for the ‘likely’ than for the ‘unlikely’ early manifestations but is similar to the ‘possible’ ones.

Conclusions: Symptom instances classified as ‘likely’ early manifestations may be the most useful to prospectively predict BD-II.