Clinical and therapeutic implications of predominant polarity in bipolar disorder
Abstract
Background To determine the clinical and therapeutic relevance of longitudinally predominant polarity for bipolar disorders long-term outcome. Method Two hundred twenty-four patients (n=224) were enrolled for the study in the Bipolar Disorders Program of Barcelona, which provides integrated care for difficult-to-treat bipolar patients derived from all over Spain, but also provides clinical care to all bipolar patients coming from a specific catchment area (Eixample Esquerre) in Barcelona. Data collection regarding predominant polarity started on October 1994 and lasted for the following ten years. Patients were divided according to the predominance of depressive or manic/hypomanic episodes. The two groups were compared regarding clinical and sociodemographic variables. Results 135 patients (60.3%) were classified as Depressive Polarity, whilst 89 (39.7%) were considered as Manic Polarity. Manic Polarity was more prevalent amongst bipolar I patients than bipolar II. Depressive Polarity was strongly associated with depressive onset of bipolar disorder. Lifetime history of attempted suicide was strongly associated with Depressive Polarity, who also had a higher mean number of suicide attempts. As for therapeutic issues, acute and maintenance use of atypical antipsychotics and conventional neuroleptics were more common amongst Manic Polarity whilst antidepressants and lamotrigine use was highly prevalent amongst Depressive Polarity. Conclusions Prevention of depression is crucial…
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Bipolar disorders present initially with a depressive episode in >50% of patients, which is considered the major burden of bipolar disorder in terms of disability and suicide risk.
“Bipolar disorders present initially with a depressive episode in >50 % of patients, which is considered the major burden of bipolar disorder in terms of disability and suicide risk”
From Efficacy of modern antipsychotics in placebo-controlled trials in bipolar depression: a meta-analysis (2010) · cites this paper as Colom et al. 2006
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- Authors
- Colom, F., Vieta, E., Daban, C., Pacchiarotti, I., & Sánchez-Moreno, J.
- Corresponding author
- Vieta, E.
- Venue
- Journal of Affective Disorders
- Publisher
- Elsevier BV
- Published
- 2006-07
- Volume
- 93
- Issue
- 1-3
- Pages
- 13-17
- ISSN
- 0165-0327 (ISSN-L)
- OpenAlex
- W2027429200
- Cited by
- 301
- References
- 16
- Citations by year
- 2026: 5 · 2025: 10 · 2024: 8 · 2023: 18 · 2022: 15 · 2021: 13 · 2020: 20 · 2019: 10 · 2018: 22 · 2017: 14 · 2016: 12 · 2015: 24 · 2014: 15 · 2013: 24 · 2012: 24
- FWCI
- 6.57
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Affective Disorders (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Stanley Medical Research Institute
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
- Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Keywords
- bipolar disorder, predominant polarity, bipolar I disorder, bipolar II disorder, suicide attempts, antidepressant use, atypical antipsychotics, lamotrigine, maintenance therapy, depression prevention, prognostic factors
- MeSH terms
- Lamotrigine, Adult, Antidepressive Agents, Bipolar Disorder, Cross-Sectional Studies, Drug Therapy, Combination, Female, Follow-Up Studies, Humans, Male, Middle Aged, Prognosis, Prospective Studies, Recurrence, Risk Factors, Socioeconomic Factors, Spain, Suicide, Attempted, Antipsychotic Agents, Triazines, Incidence, Treatment Outcome, Antimanic Agents, Diagnostic and Statistical Manual of Mental Disorders
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