Clinical correlates of patients with rapid-cycling bipolar disorder and a recent history of substance use disorder

A subtype comparison from baseline data of 2 randomized, placebo-controlled trials

Keming Gao, Marcia L. Verduin, David E. Kemp, Bryan K. Tolliver, Stephen J. Ganocy, Omar Elhaj, Sarah Bilali, Kathleen T. Brady, Robert L Findling, Joseph R. Calabrese

Research output: Contribution to journalArticle

Abstract

Objective: To compare clinical variables in patients with rapid-cycling bipolar I or II disorder and a recent history of substance use disorder (SUD). Method: Cross-sectional data from 2 studies of patients with rapid-cycling bipolar I disorder or rapid-cycling bipolar II disorder and a recent history of SUD were used to retrospectively assess the differences in clinical variables between the subtypes. The studies were conducted from November 1997 to February 2007 at University Hospitals Case Medical Center, Case Western Reserve University School of Medicine, Cleveland, Ohio. Extensive clinical interview and the Mini-International Neuropsychiatric Interview were used to ascertain DSM-IV diagnoses of rapid-cycling bipolar disorder, SUDs, and other Axis I disorders and to collect clinical variables. The Addiction Severity Index (ASI), Global Assessment Scale (GAS), and the Medical Outcomes Study 36-Item Short-Form Health Survey were used to measure the severity of impairment at the initial assessment. One-way analysis of variance or ψ2 was used for significance tests. A Bonferroni adjustment was applied for multiple comparisons. Results: Of 245 patients with rapid-cycling bipolar disorder (rapid-cycling bipolar I disorder, N = 191; rapid-cycling bipolar II disorder, N = 54) and a recent history of SUD, the demographics were similar. A significantly higher rate of panic disorder was observed in patients with rapid-cycling bipolar I disorder than in those with rapid-cycling bipolar II disorder (odds ratio = 3.72, 95% CI = 1.66 to 8.32, p = .008). A significantly higher psychiatric composite score on the ASI was also found in patients with rapid-cycling bipolar I disorder than in those with rapid-cycling bipolar II disorder even after Bonferroni adjustment (p = .0007). There were no significant differences between the subtypes in the rates of previous hospitalization or suicide attempt, early childhood verbal, physical, or sexual abuse, lifetime substance abuse or dependence, the number of SUDs or mood episodes in the last 12 months, and total or other subscale scores on ASI and GAS. Conclusion: Except for the significantly higher rate of comorbid panic disorder and higher psychiatric composite scores on the ASI in patients with rapid-cycling bipolar I disorder than in those with rapid-cycling bipolar II disorder, the other clinical variables were similar between the 2 groups.

Original languageEnglish (US)
Pages (from-to)1057-1063
Number of pages7
JournalJournal of Clinical Psychiatry
Volume69
Issue number7
StatePublished - Jul 2008
Externally publishedYes

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Bipolar Disorder
Substance-Related Disorders
Randomized Controlled Trials
Placebos
Social Adjustment
Panic Disorder
Psychiatry
Interviews
Sex Offenses
Health Surveys
Diagnostic and Statistical Manual of Mental Disorders
Suicide
Analysis of Variance
Hospitalization
Odds Ratio
Medicine
Demography
Outcome Assessment (Health Care)

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Clinical Psychology

Cite this

Clinical correlates of patients with rapid-cycling bipolar disorder and a recent history of substance use disorder : A subtype comparison from baseline data of 2 randomized, placebo-controlled trials. / Gao, Keming; Verduin, Marcia L.; Kemp, David E.; Tolliver, Bryan K.; Ganocy, Stephen J.; Elhaj, Omar; Bilali, Sarah; Brady, Kathleen T.; Findling, Robert L; Calabrese, Joseph R.

In: Journal of Clinical Psychiatry, Vol. 69, No. 7, 07.2008, p. 1057-1063.

Research output: Contribution to journalArticle

Gao, Keming ; Verduin, Marcia L. ; Kemp, David E. ; Tolliver, Bryan K. ; Ganocy, Stephen J. ; Elhaj, Omar ; Bilali, Sarah ; Brady, Kathleen T. ; Findling, Robert L ; Calabrese, Joseph R. / Clinical correlates of patients with rapid-cycling bipolar disorder and a recent history of substance use disorder : A subtype comparison from baseline data of 2 randomized, placebo-controlled trials. In: Journal of Clinical Psychiatry. 2008 ; Vol. 69, No. 7. pp. 1057-1063.
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title = "Clinical correlates of patients with rapid-cycling bipolar disorder and a recent history of substance use disorder: A subtype comparison from baseline data of 2 randomized, placebo-controlled trials",
abstract = "Objective: To compare clinical variables in patients with rapid-cycling bipolar I or II disorder and a recent history of substance use disorder (SUD). Method: Cross-sectional data from 2 studies of patients with rapid-cycling bipolar I disorder or rapid-cycling bipolar II disorder and a recent history of SUD were used to retrospectively assess the differences in clinical variables between the subtypes. The studies were conducted from November 1997 to February 2007 at University Hospitals Case Medical Center, Case Western Reserve University School of Medicine, Cleveland, Ohio. Extensive clinical interview and the Mini-International Neuropsychiatric Interview were used to ascertain DSM-IV diagnoses of rapid-cycling bipolar disorder, SUDs, and other Axis I disorders and to collect clinical variables. The Addiction Severity Index (ASI), Global Assessment Scale (GAS), and the Medical Outcomes Study 36-Item Short-Form Health Survey were used to measure the severity of impairment at the initial assessment. One-way analysis of variance or ψ2 was used for significance tests. A Bonferroni adjustment was applied for multiple comparisons. Results: Of 245 patients with rapid-cycling bipolar disorder (rapid-cycling bipolar I disorder, N = 191; rapid-cycling bipolar II disorder, N = 54) and a recent history of SUD, the demographics were similar. A significantly higher rate of panic disorder was observed in patients with rapid-cycling bipolar I disorder than in those with rapid-cycling bipolar II disorder (odds ratio = 3.72, 95{\%} CI = 1.66 to 8.32, p = .008). A significantly higher psychiatric composite score on the ASI was also found in patients with rapid-cycling bipolar I disorder than in those with rapid-cycling bipolar II disorder even after Bonferroni adjustment (p = .0007). There were no significant differences between the subtypes in the rates of previous hospitalization or suicide attempt, early childhood verbal, physical, or sexual abuse, lifetime substance abuse or dependence, the number of SUDs or mood episodes in the last 12 months, and total or other subscale scores on ASI and GAS. Conclusion: Except for the significantly higher rate of comorbid panic disorder and higher psychiatric composite scores on the ASI in patients with rapid-cycling bipolar I disorder than in those with rapid-cycling bipolar II disorder, the other clinical variables were similar between the 2 groups.",
author = "Keming Gao and Verduin, {Marcia L.} and Kemp, {David E.} and Tolliver, {Bryan K.} and Ganocy, {Stephen J.} and Omar Elhaj and Sarah Bilali and Brady, {Kathleen T.} and Findling, {Robert L} and Calabrese, {Joseph R.}",
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T1 - Clinical correlates of patients with rapid-cycling bipolar disorder and a recent history of substance use disorder

T2 - A subtype comparison from baseline data of 2 randomized, placebo-controlled trials

AU - Gao, Keming

AU - Verduin, Marcia L.

AU - Kemp, David E.

AU - Tolliver, Bryan K.

AU - Ganocy, Stephen J.

AU - Elhaj, Omar

AU - Bilali, Sarah

AU - Brady, Kathleen T.

AU - Findling, Robert L

AU - Calabrese, Joseph R.

PY - 2008/7

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N2 - Objective: To compare clinical variables in patients with rapid-cycling bipolar I or II disorder and a recent history of substance use disorder (SUD). Method: Cross-sectional data from 2 studies of patients with rapid-cycling bipolar I disorder or rapid-cycling bipolar II disorder and a recent history of SUD were used to retrospectively assess the differences in clinical variables between the subtypes. The studies were conducted from November 1997 to February 2007 at University Hospitals Case Medical Center, Case Western Reserve University School of Medicine, Cleveland, Ohio. Extensive clinical interview and the Mini-International Neuropsychiatric Interview were used to ascertain DSM-IV diagnoses of rapid-cycling bipolar disorder, SUDs, and other Axis I disorders and to collect clinical variables. The Addiction Severity Index (ASI), Global Assessment Scale (GAS), and the Medical Outcomes Study 36-Item Short-Form Health Survey were used to measure the severity of impairment at the initial assessment. One-way analysis of variance or ψ2 was used for significance tests. A Bonferroni adjustment was applied for multiple comparisons. Results: Of 245 patients with rapid-cycling bipolar disorder (rapid-cycling bipolar I disorder, N = 191; rapid-cycling bipolar II disorder, N = 54) and a recent history of SUD, the demographics were similar. A significantly higher rate of panic disorder was observed in patients with rapid-cycling bipolar I disorder than in those with rapid-cycling bipolar II disorder (odds ratio = 3.72, 95% CI = 1.66 to 8.32, p = .008). A significantly higher psychiatric composite score on the ASI was also found in patients with rapid-cycling bipolar I disorder than in those with rapid-cycling bipolar II disorder even after Bonferroni adjustment (p = .0007). There were no significant differences between the subtypes in the rates of previous hospitalization or suicide attempt, early childhood verbal, physical, or sexual abuse, lifetime substance abuse or dependence, the number of SUDs or mood episodes in the last 12 months, and total or other subscale scores on ASI and GAS. Conclusion: Except for the significantly higher rate of comorbid panic disorder and higher psychiatric composite scores on the ASI in patients with rapid-cycling bipolar I disorder than in those with rapid-cycling bipolar II disorder, the other clinical variables were similar between the 2 groups.

AB - Objective: To compare clinical variables in patients with rapid-cycling bipolar I or II disorder and a recent history of substance use disorder (SUD). Method: Cross-sectional data from 2 studies of patients with rapid-cycling bipolar I disorder or rapid-cycling bipolar II disorder and a recent history of SUD were used to retrospectively assess the differences in clinical variables between the subtypes. The studies were conducted from November 1997 to February 2007 at University Hospitals Case Medical Center, Case Western Reserve University School of Medicine, Cleveland, Ohio. Extensive clinical interview and the Mini-International Neuropsychiatric Interview were used to ascertain DSM-IV diagnoses of rapid-cycling bipolar disorder, SUDs, and other Axis I disorders and to collect clinical variables. The Addiction Severity Index (ASI), Global Assessment Scale (GAS), and the Medical Outcomes Study 36-Item Short-Form Health Survey were used to measure the severity of impairment at the initial assessment. One-way analysis of variance or ψ2 was used for significance tests. A Bonferroni adjustment was applied for multiple comparisons. Results: Of 245 patients with rapid-cycling bipolar disorder (rapid-cycling bipolar I disorder, N = 191; rapid-cycling bipolar II disorder, N = 54) and a recent history of SUD, the demographics were similar. A significantly higher rate of panic disorder was observed in patients with rapid-cycling bipolar I disorder than in those with rapid-cycling bipolar II disorder (odds ratio = 3.72, 95% CI = 1.66 to 8.32, p = .008). A significantly higher psychiatric composite score on the ASI was also found in patients with rapid-cycling bipolar I disorder than in those with rapid-cycling bipolar II disorder even after Bonferroni adjustment (p = .0007). There were no significant differences between the subtypes in the rates of previous hospitalization or suicide attempt, early childhood verbal, physical, or sexual abuse, lifetime substance abuse or dependence, the number of SUDs or mood episodes in the last 12 months, and total or other subscale scores on ASI and GAS. Conclusion: Except for the significantly higher rate of comorbid panic disorder and higher psychiatric composite scores on the ASI in patients with rapid-cycling bipolar I disorder than in those with rapid-cycling bipolar II disorder, the other clinical variables were similar between the 2 groups.

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