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Bipolar II illness: course and outcome over a five-year period

Published online by Cambridge University Press:  09 July 2009

William Coryell ,
Martin Keller ,
Jean Endicott ,
Nancy Andreasen ,
Paula Clayton  and
Robert Hirschfeld
William Coryell*
Affiliation:
National Institute of Mental Health Collaborative Program on the Psychobiology of Depression–Clinical Studies, University of Iowa, USA
Martin Keller
Affiliation:
National Institute of Mental Health Collaborative Program on the Psychobiology of Depression–Clinical Studies, University of Iowa, USA
Jean Endicott
Affiliation:
National Institute of Mental Health Collaborative Program on the Psychobiology of Depression–Clinical Studies, University of Iowa, USA
Nancy Andreasen
Affiliation:
National Institute of Mental Health Collaborative Program on the Psychobiology of Depression–Clinical Studies, University of Iowa, USA
Paula Clayton
Affiliation:
National Institute of Mental Health Collaborative Program on the Psychobiology of Depression–Clinical Studies, University of Iowa, USA
Robert Hirschfeld
Affiliation:
National Institute of Mental Health Collaborative Program on the Psychobiology of Depression–Clinical Studies, University of Iowa, USA
*
1Address for correspondence: Dr William Coryell, University of Iowa, Department of Psychiatry, 500 Newton Road, Iowa City, 1A 52242, USA.
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Synopsis

A five year semi-annual follow-up of patients with non-bipolar (N = 442), bipolar II (N = 64) and bipolar I (N = 53) major depression tracked the courses of prospectively observed major depressive, hypomanic and manic syndromes. In all three groups, depression was much more likely in any given week than was hypomania or mania. However, during the majority of weeks, no full syndrome was present and none of the groups exhibited evidence of continuing psychosocial deterioration. Though all three groups exhibited similar times to recovery from index and subsequent major depressive episodes, both bipolar groups had substantially higher relapse rates and developed more episodes of major depression, hypomania and mania. The two bipolar groups, in turn, differed by the severity of manic-like syndromes and thus remained diagnostically stable; the bipolar II patients were much less likely to develop full manic syndromes or to be hospitalized during follow-up. In conjunction with family study data showing that bipolar II disorder breeds true, these data support the separation of bipolar I and bipolar II affective disorder.

Type
Research Article
Information
Psychological Medicine , Volume 19 , Issue 1 , February 1989 , pp. 129 - 141
Copyright
Copyright © Cambridge University Press 1989

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