Hostname: page-component-848d4c4894-x24gv Total loading time: 0 Render date: 2024-05-07T01:48:10.854Z Has data issue: false hasContentIssue false

Predicting the course and outcome of bipolar disorder: A review

Published online by Cambridge University Press:  16 April 2020

T. Treuer
Affiliation:
Area Medical Center Vienna, Eli Lilly & Company, 1075 Budapest, Madach u13–14, Hungary
M. Tohen*
Affiliation:
University of Texas Health Science Center, San Antonio, Texas78229, USA
*
*Corresponding author. Tel.: +1 210 567 5329; fax: +1 210 567 8570. E-mail address: tohen@uthscsa.edu (M. Tohen).
Get access

Abstract

Despite of advances in pharmacological and non-pharmacological treatments, bipolar disorder often entails multiple relapses and impaired psychological functioning. The extent to which modern treatments have influenced the natural course of a mental disorder is uncertain. Prediction of the course and outcome of bipolar disorders continues to be challenging, despite the multiple research efforts worldwide. Due to a lack of laboratory diagnostic tests and biomarkers, psychiatric interview and examination provide the basis for outcome prediction. While considered to have more favorable prognosis than schizophrenia, it is not uncommon for bipolar disorder to include persisting alterations of psychosocial functioning. Although long-term symptomatic remission does not guarantee functional recovery, it may have a favorable impact on long-term overall prognosis. The high degree of treatment resistance in patients with bipolar disorder highlights the need to develop better identification of outcome predictors, prognosis and treatment intervention, designed to reverse or prevent this illness burden. This review summarizes the main factors involved in predicting the course and outcome of bipolar disorder.

Type
Bipolar Disorder
Copyright
Copyright © Elsevier Masson SAS 2010

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Akiskal, HS, Kilzieh, N, Maser, JD, Clayton, PJ, Schettler, PJ, Traci Shea, Met al.The distinct temperament profiles of bipolar I, bipolar II and unipolar patients. J Affect Disord 2006;92:1933.CrossRefGoogle ScholarPubMed
Akiskal, HS, Akiskal, KK, Perugi, G, Toni, C, Ruffolo, G, Tusini, GBipolar II and anxious reactive “comorbidity”: toward better phenotypic characterization suitable for genotyping. J Affect Disord 2006;96:239247.CrossRefGoogle ScholarPubMed
American Psychiatric Association Practice guideline for the treatment of patients with bipolar disorder (revision). Am J Psychiatry 2002;159:150.Google Scholar
Angst, J, Gamma, A, Sellaro, R, Lavori, PW, Zhang, HRecurrence of bipolar disorders and major depression. A life-long perspective. Eur Arch Psychiatry Clin Neurosci 2003;253:236240.CrossRefGoogle ScholarPubMed
Angst, J, Gamma, A, Benazzi, F, Ajdacic, V, Eich, D, Rossler, WToward a redefinition of subthreshold bipolarity: epidemiology and proposed criteria for bipolar-II, minor bipolar disorders and hypomania. J Affect Disord 2003;73:133146.CrossRefGoogle Scholar
Baca-Garcia, E, Perez-Rodriguez, MM, Basurte-Villamor, I, López-Castromán, J, Fernandez del Moral, AL, Jimenez-Arriero, MAet al.Diagnostic stability and evolution of bipolar disorder in clinical practice: a prospective cohort study. Acta Psychiatr Scand 2007;115:473480.CrossRefGoogle ScholarPubMed
Baethge, C, Baldessarini, RJ, Khalsa, HM, Hennen, J, Salvatore, P, Tohen, MSubstance abuse in first-episode bipolar I disorder: Indications for early intervention. Am J Psychiatry 2005;162:10081010.CrossRefGoogle ScholarPubMed
Balázs, J, Benazzi, F, Rihmer, Z, Rihmer, A, Akiskal, KK, Akiskal, HSThe close link between suicide attempts and mixed (bipolar) depression: implications for suicide prevention. J Affect Disord 2006;91:133138.CrossRefGoogle ScholarPubMed
Benazzi, FDoes temperamental instability support: a continuity between bipolar II disorder and major depressive disorder?. Eur Psychiatry 2006;21:274279.CrossRefGoogle ScholarPubMed
Berk, M, Hallam, KT, McGorry, PDThe potential utility of a staging model as a course specifier: a bipolar disorder perspective. J Affect Disord 2007;100:279281.CrossRefGoogle ScholarPubMed
Birmaher, B, Axelson, DCourse and outcome of bipolar spectrum disorder in children and adolescents: a review of the existing literature. Dev Psychopathol 2006;18:10231035.CrossRefGoogle ScholarPubMed
Brown, GR, McBride, L, Bauer, MS, Williford, WOCooperative Studies Program 430 Study Team. Impact of childhood abuse on the course of bipolar disorder: a replication study in U.S. veterans. J Affect Disord 2005;89:5767.CrossRefGoogle ScholarPubMed
Burdick, KE, Goldberg, JF, Harrow, M, Faull, RN, Malhotra, AKNeurocognition as a stable endophenotype in bipolar disorder and schizophrenia. J Nerv Ment Dis 2006;194:255260.CrossRefGoogle Scholar
Calabrese, JR, Vieta, E, El-Mallakh, R, Findling, RL, Youngstrom, EA, Elhaj, Oet al.Mood state at study entry as predictor of the polarity of relapse in bipolar disorder. Biol Psychiatry 2004;56:957963.CrossRefGoogle ScholarPubMed
Calabrese, JR, Shelton, MD, Rapport, DJ, Youngstrom, EA, Jackson, K, Bilali, Set al.A 20-month, double-blind, maintenance trial of lithium versus divalproex in rapid-cycling bipolar disorder. Am J Psychiatry 2005;162:21522161.CrossRefGoogle ScholarPubMed
Chaudhury, SR, Grunebaum, MF, Galfalvy, HC, Burke, AKet al.Does first episode polarity predict risk for suicide attempt in bipolar disorder?. J Affect Disord 2007;104:245250.CrossRefGoogle ScholarPubMed
Conus, P, Berk, M, McGorry, PDPharmacological treatment in the early phase of bipolar disorders: what stage are we at?. Aust N Z J Psychiatry 2006;40:199207.CrossRefGoogle Scholar
Coryell, W, Keller, M, Endicott, J, Andreasen, N, Clayton, Pet al.Bipolar II illness: course and outcome over a five-year period. Psychol Med 1989;19:129141.CrossRefGoogle Scholar
Coryell, W, Endicott, J, Keller, MRapidly cycling affective disorder: Demographics, diagnosis, family history, and course. Arch Gen Psychiatry 1992;49:126131.CrossRefGoogle ScholarPubMed
Cruz, N, Vieta, E, Comes, M, Haro, JM, Reed, C, Bertsch, JEMBLEM Advisory Board. Rapid-cycling bipolar I disorder: course and treatment outcome of a large sample across Europe. J Psychiatr Res 2008;42(13):10681075.CrossRefGoogle ScholarPubMed
DelBello, MP, Hanseman, D, Adler, CM, Fleck, DE, Strakowski, SMTwelve-month outcome of adolescents with bipolar disorder following first hospitalization for a manic or mixed episode. Am J Psychiatry 2007;164:582590.CrossRefGoogle ScholarPubMed
Dienes, KA, Hammen, C, Henry, RM, Cohen, AN, Daley, SEThe stress sensitization hypothesis: understanding the course of bipolar disorder. J Affect Disord 2006;95:4349.CrossRefGoogle ScholarPubMed
Duffy, A, Alda, M, Trinneer, A, Demidenko, N, Grof, P, Goodyer, IMTemperament, life events, and psychopathology among the offspring of bipolar parents. Eur Child Adolesc Psychiatry 2007;16:222228.CrossRefGoogle ScholarPubMed
Franchini, L, Zanardi, R, Smeraldi, E, Gasperini, MEarly onset of lithium prophylaxis as a predictor of good long-term outcome. Eur Arch Psychiatry Clin Neurosci 1999;249:227230.CrossRefGoogle ScholarPubMed
Geller, B, Fox, LW, Clark, KARate and predictors of prepubertal bipolarity during follow-up of 6- to 12-year-old depressed children. J Am Acad Child Adolesc Psychiatry 1994;33:461468.CrossRefGoogle ScholarPubMed
Goldberg, JF, Harrow, M, Grossman, LSCourse and outcome in bipolar affective disorder: a longitudinal follow-up study. Am J Psychiatry 1995;152:379384.Google ScholarPubMed
Hirschfeld, RM, Lewis, L, Vornik, LAPerceptions and impact of bipolar disorder: how far have we really come? Results of the national depressive and manic-depressive association 2000 survey of individuals with bipolar disorder. J Clin Psychiatry 2003;64:161174.CrossRefGoogle ScholarPubMed
Jamison, KRSuicide and bipolar disorder. J Clin Psychiatry 2000;61:4751.Google ScholarPubMed
Judd, LL, Schettler, PJ, Solomon, DA, Maser, JD, Coryell, W, Endicott, Jet al.Psychosocial disability and work role function compared across the long-term course of bipolar I, bipolar II and unipolar major depressive disorders. J Affect Disord 2008;108:4958.CrossRefGoogle ScholarPubMed
Kawa, I, Carter, JD, Joyce, PR, Doughty, CJ, Frampton, CM, Wells, JEet al.Gender differences in bipolar disorder: age of onset, course, comorbidity, and symptom presentation. Bipolar Disord 2005;7:119125.CrossRefGoogle ScholarPubMed
Keller, MB, Lavori, PW, Coryell, W, Andreasen, NC, Endicott, J, Clayton, PJet al.Differential outcome of pure manic, mixed/cycling, and pure depressive episodes in patients with bipolar illness. JAMA 1986;255:31383142.CrossRefGoogle ScholarPubMed
Kessler, RC, Akiskal, HS, Angst, J, Guyer, M, Hirschfeld, RM, Merikangas, KRet al.Validity of the assessment of bipolar spectrum disorders in the WHO CIDI 3.0. J Affect Disord 2006;96:259269.CrossRefGoogle ScholarPubMed
Ketter, TA, Houston, JP, Adams, DH, Risser, RC, Meyers, AL, Williamson, DJet al.Differential efficacy of olanzapine and lithium in preventing manic or mixed recurrence in patients with bipolar I disorder based on number of previous manic or mixed episodes. J Clin Psychiatry 2006;67:95101.CrossRefGoogle ScholarPubMed
Krishnan, KRPsychiatric and medical comorbidities of bipolar disorder. Psychosom Med 2005;67:18.CrossRefGoogle ScholarPubMed
Kupfer, DJThe increasing medical burden in bipolar disorder. JAMA 2005;293:25282530.CrossRefGoogle ScholarPubMed
Leverich, GS, Post, RM, Keck, PE Jr., Altshuler, LL, Frye, MA, Kupka, RWet al.The poor prognosis of childhood-onset bipolar disorder. J Pediatr 2007;150:485490.CrossRefGoogle ScholarPubMed
Malhi, GS, Ivanovski, B, Hadzi-Pavlovic, D, Mitchell, PB, Vieta, E, Sachdev, PNeuropsychological deficits and functional impairment in bipolar depression, hypomania and euthymia. Bipolar Disord 2005;9:114125.CrossRefGoogle Scholar
Marangell, LBThe importance of subsyndromal symptoms in bipolar disorder. J Clin Psychiatry 2004;65(Suppl. 10):2427.Google ScholarPubMed
Marangell, LB, Dennehy, EB, Miyahara, S, Wisniewski, SR, Bauer, MS, Rapaport, MHet al.The functional impact of subsyndromal depressive symptoms in bipolar disorder: data from STEP-BD. J Affect Disord 2009;114(1–3):5867.CrossRefGoogle ScholarPubMed
Marangell, LB, Dennehy, EB, Miyahara, S, Wisniewski, SR, Bauer, MS, Rapaport, MHet al.The functional impact of subsyndromal depressive symptoms in bipolar disorder: data from STEP-BD. J Affect Disord 2009;114:5867.CrossRefGoogle ScholarPubMed
Marneros, AMood disorders: epidemiology and natural history. Psychiatry 2006;4:119122.CrossRefGoogle Scholar
Marneros, A, Deister, A, Rohde, APsychopathological and social status of patients with affective, schizophrenic and schizoaffective disorders after long-term course. Acta Psychiatr Scand 1990;82:352358.CrossRefGoogle ScholarPubMed
Marneros, A, Deister, A, Rohde, APhenomenologic constellations of persistent alterations in idiopathic psychoses. An empirical comparative study (German). Nervenarzt 1991;62:676681.Google Scholar
Martinez-Aran, A, Vieta, E, Reinares, M, Colom, F, Torrent, C, Sánchez-Moreno, Jet al.Cognitive function across manic or hypomanic, depressed, and euthymic states in bipolar disorder. Am J Psychiatry 2005;161:262270.CrossRefGoogle Scholar
Martinez-Aran, A, Vieta, E, Torrent, C, Sanchez-Moreno, J, Goikolea, JM, Salamero, Met al.Functional outcome in bipolar disorder: the role of clinical and cognitive factors. Bipolar Disord 2007;9:103113.CrossRefGoogle ScholarPubMed
Mazza, M, Mandelli, L, Di Nicola, M, Harnic, D, Catalano, V, Tedeschi, Det al.Clinical features, response to treatment and functional outcome of bipolar disorder patients with and without co-occurring substance use disorder: 1-year follow-up. J Affect Disord 2009;115:2735.CrossRefGoogle ScholarPubMed
McIntyre, RS, Soczynska, JK, Beyer, JL, Woldeyohannes, HO, Law, CW, Miranda, Aet al.Medical comorbidity in bipolar disorder: re-prioritizing unmet needs. Curr Opin Psychiatry 2007;20:406416.CrossRefGoogle ScholarPubMed
Meeks, SBipolar disorder in the latter half of life: symptom presentation, global functioning and age of onset. J Affect Disord 1999;52:161167.CrossRefGoogle ScholarPubMed
Merikangas, KR, Akiskal, HS, Angst, J, Greenberg, PE, Hirschfeld, RM, Petukhova, Met al.Lifetime and 12-month prevalence of bipolar spectrum disorder in the National Comorbidity Survey replication. Arch Gen Psychiatry 2007;64:543552.CrossRefGoogle ScholarPubMed
Miklowitz, DJ, Wisniewski, SR, Miyahara, S, Otto, MW, Sachs, GSPerceived criticism from family members as a predictor of the one-year course of bipolar disorder. Psychiatry Res 2006;136:101111.CrossRefGoogle Scholar
Moorhead, TW, McKirdy, J, Sussmann, JE, Hall, J, Lawrie, SM, Johnstone, ECet al.Progressive gray matter loss in patients with bipolar disorder. Biol Psychiatry 2007;62:894900.CrossRefGoogle ScholarPubMed
Nolen, WA, Luckenbaugh, DA, Altshuler, LL, Suppes, T, McElroy, SL, Frye, MAet al.Correlates of 1-year prospective outcome in bipolar disorder: results from the Stanley Foundation Bipolar Network. Am J Psychiatry 2004;161:14471454.CrossRefGoogle ScholarPubMed
Ostacher, MJ, Nierenberg, AA, Perlis, RH, Eidelman, P, Borrelli, DJ, Tran, TBet al.The relationship between smoking and suicidal behavior, comorbidity, and course of illness in bipolar disorder. J Clin Psychiatry 2006;67:19071911.CrossRefGoogle ScholarPubMed
Perlis, RH, Delbello, MP, Miyahara, S, Wisniewski, SR, Sachs, GS, Nierenberg, AASTEP-BD investigators. Revisiting depressive-prone bipolar disorder: polarity of initial mood episode and disease course among bipolar I systematic treatment enhancement program for bipolar disorder participants. Biol Psychiatry 2005;58:549553.CrossRefGoogle ScholarPubMed
Perlis, RH, Ostacher, MJ, Patel, JK, Marangell, LB, Zhang, H, Wisniewski, SRet al.Predictors of recurrence in bipolar disorder: primary outcomes from the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD). Am J Psychiatry 2006;163:217224.CrossRefGoogle Scholar
Post, RM, Leverich, GSThe role of psychosocial stress in the onset and progression of bipolar disorder and its comorbidities: the need for earlier and alternative modes of therapeutic intervention. Dev Psychopathol 2006;18:11811211.CrossRefGoogle ScholarPubMed
Post, RM, Leverich, GS, Altshuler, LL, Frye, MA, Suppes, TM, Keck, PE Jr.et al.An overview of recent findings of the Stanley Foundation Bipolar Network (Part I). Bipolar Disord 2003;5:310319.CrossRefGoogle Scholar
Röttig, D, Röttig, S, Brieger, P, Marneros, ATemperament and personality in bipolar I patients with and without mixed episodes. J Affect Disord 2007;104:94102.CrossRefGoogle ScholarPubMed
Salvatore, P, Tohen, M, Khalsa, HM, Baethge, C, Tondo, L, Baldessarini, RJLongitudinal research on bipolar disorders. Epidemiol Psichiatr Soc 2007;16:109117.CrossRefGoogle ScholarPubMed
Simon, GE, Bauer, MS, Ludman, EJ, Operskalski, BH, Unützer, JMood symptoms, functional impairment, and disability in people with bipolar disorder: specific effects of mania and depression. J Clin Psychiatry 2007;68:12371245.CrossRefGoogle ScholarPubMed
Simon, NM, Zalta, AK, Otto, MW, Ostacher, MJ, Fischmann, D, Chow, CWet al.The association of comorbid anxiety disorders with suicide attempts and suicidal ideation in outpatients with bipolar disorder. J Psychiatr Res 2007;41:255264.CrossRefGoogle ScholarPubMed
Strakowski, SM, Keck, PE Jr., McElroy, SL, West, SA, Sax, KW, Hawkins, JMet al.Twelve-month outcome after a first hospitalization for affective psychosis. Arch Gen Psychiatry 1998;55:4955.CrossRefGoogle ScholarPubMed
Strakowski, SM, DelBello, MP, Fleck, DE, Adler, CM, Anthenelli, RM, Keck, PE Jr.et al.Effects of co-occurring cannabis use disorders on the course of bipolar disorder after a first hospitalization for mania. Arch Gen Psychiatry 2007;64:5764.CrossRefGoogle ScholarPubMed
Swann, AC, Bowden, CL, Calabrese, JR, Dilsaver, SC, Morris, DDDifferential effect of number of previous episodes of affective disorder on response to lithium or divalproex in acute mania. Am J Psychiatry 1999;156:12641266.Google ScholarPubMed
Thompson, KN, Conus, PO, Ward, JL, Phillips, LJ, Koutsogiannis, J, Leicester, Set al.The initial prodrome to bipolar affective disorder: prospective case studies. J Affect Disord 2003;77:7985.CrossRefGoogle ScholarPubMed
Tijssen, MJ, van Os, J, Wittchen, HU, Lieb, R, Beesdo, K, Mengelers, Ret al.Evidence that bipolar disorder is the poor outcome fraction of a common developmental phenotype: an 8-year cohort study in young people. Psychol Med 2009;11:111. [Epub ahead of print]Google Scholar
Tohen, M, Comorbidity in affective disorders New York: Marcel Dekker Inc; 1999.Google Scholar
Tohen, M, Waternaux, CM, Tsuang, MT, Hunt, ATFour year follow-up of twenty-four first-episode manic patients. J Affect Disord 1990;19:7986.CrossRefGoogle ScholarPubMed
Tohen, M, Waternaux, CM, Tsuang, MTOutcome in Mania. A 4-year prospective follow-up of 75 patients utilizing survival analysis. Arch Gen Psych 1990;47:11061111.CrossRefGoogle Scholar
Tohen, M, Tsuang, MT, Goodwin, DCPrediction of outcome in mania by mood-congruent or mood-incongruent psychotic features. Am J Psychiatry 1992;149:15801584.Google ScholarPubMed
Tohen, M, Shulman, KI, Satlin, AFirst-episode mania in late life. Am J Psychiatry 1994;151:130132.Google ScholarPubMed
Tohen, M, Greenfield, SF, Weiss, RD, Zarate, CA, Vagge, LThe effect of comorbid substance use disorders on the course of bipolar disorder. Harv Rev Psych 1998;6:133141.CrossRefGoogle ScholarPubMed
Tohen, M, Hennen, J, Zarate, C, Baldessarini, RJ, Strakowski, S, Stoll, ALet al.The McLean/Harvard First Episode Project: Two-year syndromal and functional recovery in 219 cases of major affective disorders with psychotic features. Am J Psychiatry 2000;157:220228.CrossRefGoogle ScholarPubMed
Tohen, M, Zarate, CA Jr., Hennen, J, Khalsa, HM, Strakowski, SM, Gebre-Medhin, Pet al.The McLean-Harvard First-Episode Mania Study: prediction of recovery and first recurrence. Am J Psychiatry 2003;160:20992107.CrossRefGoogle ScholarPubMed
Tohen, M, Bowden, CL, Calabrese, JR, Lin, D, Forrester, TD, Sachs, GSet al.Influence of sub-syndromal symptoms after remission from manic or mixed episodes. Br J Psychiatry 2006;189:515519.CrossRefGoogle ScholarPubMed
Tohen, M, Frank, E, Bowden, CL, Colom, F, Ghaemi, NS, Yatham, LNet al.The International Society of Bipolar Disorders (ISBD) Task Force on the nomenclature of course and outcome of bipolar disorders. Bipolar Disord 2009;11:453473.CrossRefGoogle ScholarPubMed
Tsai, SM, Chen, C, Kuo, C, Lee, J, Lee, H, Strakowski, SM15-year outcome of treated bipolar disorder. J Affect Disord 2001;63:215220.CrossRefGoogle ScholarPubMed
Varga, M, Magnusson, A, Flekkøy, K, Rønneberg, U, Opjordsmoen, SInsight, symptoms and neurocognition in bipolar I patients. J Affect Disord 2006;91:19.CrossRefGoogle ScholarPubMed
Wittchen, HU, Mhlig, S, Pezawas, LNatural course and burden of bipolar disorders. Int J Neuropsychopharmacol 2003;6:145154.CrossRefGoogle ScholarPubMed
Submit a response

Comments

No Comments have been published for this article.