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A Longitudinal Mirror-Image Assessment of Morbidity in Bipolar Disorder

Published online by Cambridge University Press:  14 November 2016

D.J. Martino ,
C. Samamé ,
E. Marengo ,
A. Igoa ,
M. Scápola  and
S.A. Strejilevich
D.J. Martino*
Affiliation:
Bipolar Disorder Program, Neuroscience Institute, Favaloro University, Solís 461Buenos Aires, Argentina National Council of Scientific and Technical Research (CONICET) avenue Rivadavia 1917Buenos Aires, Argentina
C. Samamé
Affiliation:
Bipolar Disorder Program, Neuroscience Institute, Favaloro University, Solís 461Buenos Aires, Argentina National Council of Scientific and Technical Research (CONICET) avenue Rivadavia 1917Buenos Aires, Argentina
E. Marengo
Affiliation:
Bipolar Disorder Program, Neuroscience Institute, Favaloro University, Solís 461Buenos Aires, Argentina
A. Igoa
Affiliation:
Bipolar Disorder Program, Neuroscience Institute, Favaloro University, Solís 461Buenos Aires, Argentina
M. Scápola
Affiliation:
Bipolar Disorder Program, Neuroscience Institute, Favaloro University, Solís 461Buenos Aires, Argentina
S.A. Strejilevich
Affiliation:
Bipolar Disorder Program, Neuroscience Institute, Favaloro University, Solís 461Buenos Aires, Argentina Institute of Cognitive Neurology (INECO) Pacheco de Melo 1860, Buenos Aires, Argentina
*
* Corresponding author. at: Gurruchaga 2463, 18 C (C1425FEK) Ciudad Autónoma de Buenos Aires, Argentina. Tel./Fax: +5411 4833 2424. E-mail address:diejmartino@gmail.com (D.J. Martino).
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Abstract

Background

Evidence about the clinical course of bipolar disorder is inconsistent and limited. The aim of this study was to assess changes in morbidity in patients with bipolar disorder along a mean follow-up period of 80 months.

Methods

Based on a mirror-image design, the follow-up period of each patient was divided into two halves. Then, three measures of morbidity — number of affective episodes, time spent ill, and cycle length — were recorded and compared between each half of the follow-up period.

Results

On average, there was a trend to a smaller amount of time spent with subclinical symptomatology during the second half of the follow-up period. In contrast, there were no differences in terms of number of episodes, time spent with clinical symptoms, or cycle length between the first and second half of the follow-up period. A subgroup analysis identified 21.9% of patients with consistent data of a worsening during follow-up.

Conclusions

The results suggest that, on average, there is stability or slight improvement of clinical morbidity over the course of BD. Then, worsening of the clinical course may be a feature of a subgroup of patients rather than an inherent characteristic of the disorder. These subgroups or patient profiles could represent an opportunity for further studies to assess clinical, pathophysiologic, and therapeutic features associated with them.

Keywords

Long-termCycle lengthRecurrencesTime spent illStaging
Type
Original article
Information
European Psychiatry , Volume 40 , February 2017 , pp. 55 - 59
Copyright
Copyright © Elsevier Masson SAS 2017

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