Zeschel, Eike, Correll, Christoph U., Haussleiter, Ida S., Krueger-Oezguerdal, Seza, Leopold, Karolina, Pfennig, Andrea, Bechdolf, Andreas, Bauer, Michael and Juckel, Georg (2013). The bipolar disorder prodrome revisited: Is there a symptomatic pattern? J. Affect. Disord., 151 (2). S. 551 - 561. AMSTERDAM: ELSEVIER. ISSN 1573-2517

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Abstract

Objectives: To assess the phenomenology and course of pre-(hypo)manic and pre-depressed prodromal symptoms, including mood swings, as precursors of bipolar disorder (BD) in a German multi-center study. Methods: Semi-structured interviews [Bipolar Prodrome Symptom Scale-Retrospective (BPSS-R); Semi-structured Interview for Mood Swings] were administered to patients within 8 years of BD (BD I, BD II) onset. Results: Forty two outpatients were included (40.5% male, mean age 35.1 +/- 10.0 years, illness onset at 30.5 +/- 9.5 years) Feeling extremely energetic (85.7%), racing thoughts (78.6%), physical agitation (76.2%), overtalkativeness (71.4%), and low sleep requirement (71.4%) occurred most frequently prior to the first (hypo) manic episode, whereas depressed mood (83.0%), reduced vitality (81.0%), physical exhaustion (78.6%), tiredness (76.2%), and insomnia (66.7%) preceded pre-depressively. Mood lability (p=.006), odd ideas (p=.003) and the psychosis index score (p=.003) differed significantly in prevalence depending on the episodes mood. Extremely energetic (p=.046), overtalkativeness (p<.001), and racing thoughts (p=.013) lasted significantly longer prior to depression. Neither severity nor frequency of prodromal symptoms differed significantly. Most of the symptoms emerged during the proximal prodromal phase. Links between mood swings and subsequent BD were found. Limitations: Symptoms were evaluated retrospectively with self-reporting tools in bipolar patients from academic treatment settings without comparison to clinical controls. Conclusions: Not only specific depressive or manic but also general symptoms occurred prior to both affective episodes. The pre-depressive prodrome lasted longer than the pre-manic one, but severity and frequency did not differ significantly. Mood swings and disturbed diurnal rhythm occurred prior to both episodes as early signs of BD. (C) 2013 Elsevier B.V. All rights reserved

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Zeschel, EikeUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Correll, Christoph U.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Haussleiter, Ida S.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Krueger-Oezguerdal, SezaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Leopold, KarolinaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Pfennig, AndreaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Bechdolf, AndreasUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Bauer, MichaelUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Juckel, GeorgUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-472982
DOI: 10.1016/j.jad.2013.06.043
Journal or Publication Title: J. Affect. Disord.
Volume: 151
Number: 2
Page Range: S. 551 - 561
Date: 2013
Publisher: ELSEVIER
Place of Publication: AMSTERDAM
ISSN: 1573-2517
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
HIGH-RISK; TEMPERAMENT; MANIA; ONSET; ADOLESCENTS; DEPRESSION; RATIONALE; PSYCHOSIS; DIAGNOSIS; CRITERIAMultiple languages
Clinical Neurology; PsychiatryMultiple languages
URI: http://kups.ub.uni-koeln.de/id/eprint/47298

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