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Cited by 217Bipolar Disorder and TreatmentSchizophrenia research and treatmentPersonality Disorders and Psychopathology

History of illness prior to a diagnosis of bipolar disorder or schizoaffective disorder

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Berk, M., Dodd, S., Callaly, P., Berk, L., Fitzgerald, P., de Castella, A.R., Filia, S., Filia, K. +6 more·2007·Journal of Affective Disorders
DOI 10.1016/j.jad.2007.01.027
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Abstract

Background There are obstacles to early identification of bipolar disorder. Identifying and treating illness early in its time course may be associated with a better prognosis.Methods A questionnaire was administered at interview, when the participant was euthymic, to participants (n=240) enrolled in the Bipolar Comprehensive Outcomes Study (BCOS). Information was collected about the sequential timeline of specific symptoms of mental illness up to when they first received a diagnosis of Bipolar Disorder or Schizoaffective Disorder.Results Any symptoms of mental illness were first experienced at 17.5 years (median; Inter Quartile Range (IQR) 13.8-24.3; n=216) and mood swings at 18.0 years (IQR 14-25; n=197). Symptoms of depression were experienced at 18.0 years (IQR 14-25; n=197), a full episode of depression at 21.2 years (IQR 17-28.5; n=200), symptoms of mania at 21.0 years (IQR 16.8-29.5; n=212) and a full episode of mania at 24.1 years (IQR 19-30.5; n=205). Medical treatment was sought at 24.0 years (IQR 19-31.5; n=217). Participants received a diagnosis of Bipolar Disorder or Schizoaffective Disorder at 30.0 years (IQR 23-37.3; n=215). Having had a previous diagnosis other than Bipolar Disorder or Schizoaffective Disorder was reported by 120 of 216 participants who answered this question, most commonly unipolar depression (26.6%). Diagnostic delay was greater in individuals with early onset disorder.Conclusions Participants typically experience a long sequential course of symptoms, episodes, treatments and diagnosis. The polarity of onset is most commonly depressive, and subthreshold symptoms tend to precede threshold symptoms of both polarities.Limitations Data were collected retrospectively.

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  • An alternative threshold has been to experience any two depressive symptoms most of the time for at least two weeks, associated with evidence of social dysfunction.

    “An alternative has been to experience any two depressive symptoms most of the time for at least two weeks, associated with evidence of social dysfunction. 64”

    From Time for united action on depression: a Lancet–World Psychiatric Association Commission (2022) · cites this paper as [64]

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Authors
Berk, M., Dodd, S., Callaly, P., Berk, L., Fitzgerald, P., de Castella, A. R., Filia, S., Filia, K., Tahtalian, S., Biffin, F., Kelin, K., Smith, M., Montgomery, W., & Kulkarni, J.
Affiliations
  • Barwon Health (AU)
  • The Alfred Hospital (AU)
  • Eli Lilly (Australia) (AU)
  • Western Sydney University (AU)
ORCID
Venue
Journal of Affective Disorders
Publisher
Elsevier BV
Published
2007-11
Volume
103
Issue
1-3
Pages
181-186
ISSN
0165-0327 (ISSN-L)
DOI
10.1016/j.jad.2007.01.027
OpenAlex
W2148406811
Cited by
217
References
23
Citations by year
2026: 1 · 2025: 6 · 2024: 14 · 2023: 10 · 2022: 13 · 2021: 11 · 2020: 14 · 2019: 13 · 2018: 9 · 2017: 9 · 2016: 10 · 2015: 14 · 2014: 6 · 2013: 14 · 2012: 27
FWCI
6.24
Type
journal article
Language
en
Open access
Licence
Locations
  • Journal of Affective Disorders (publishedVersion)
  • PubMed (publishedVersion)
  • Figshare (submittedVersion, cc-by)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
  • Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
  • Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
Keywords
bipolar disorder, schizoaffective disorder, early-onset bipolar disorder, delayed diagnosis, mood episodes, depression, mania, major depressive disorder, subthreshold symptoms
MeSH terms
Adolescent, Adult, Age Factors, Bipolar Disorder, Depressive Disorder, Diagnosis, Differential, Female, Humans, Longitudinal Studies, Male, Medical History Taking, Prospective Studies, Psychotic Disorders, Psychotropic Drugs, Victoria, Cohort Studies, Outcome Assessment, Health Care, Disease Progression, Early Diagnosis

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