TY - JOUR
T1 - Rapid switching of mood in families with familial bipolar disorder
AU - Nwulia, Evaristus A.
AU - Zandi, Peter P.
AU - McInnis, Melvin G.
AU - DePaulo, J. Raymond
AU - MacKinnon, Dean F.
PY - 2008/8
Y1 - 2008/8
N2 - Objective: Rapid switching of moods in bipolar disorder has been associated with early age at onset, panic comorbidity, and suicidality. This study aims to confirm these associations and investigate other potential correlates of rapid switching of mood using families from a multisite bipolar linkage study. Methods: The subjects were comprised of 1,143 probands and relatives with diagnosis of bipolar disorder. All subjects were interviewed directly with a standard diagnostic instrument, and all subjects who met criteria for bipolar disorder were asked if their moods had ever switched rapidly. Results: Individuals with rapid mood switching had significantly earlier age at onset (18 versus 21years, p < 0.00001), higher comorbid anxiety (47% versus 26%, p < 0.00001) and substance use disorders (52% versus 42%, p = 0.0006), higher rate of violent behavior (6% versus 3%, p < 0.004), suicidal behavior (46% versus 31%, p < 0.00001), and nonsuicidal self-harm (13% versus 6%, p < 0.0002). Multiple logistic regression analysis found significant net effects on rapid mood switching for early emergence of symptoms [odds ratio (OR) = 0.62; 95% confidence interval (CI): 0.45-0.85]; anxiety comorbidity (OR = 2.31; 95% CI: 1.34-3.98); and hypersensitivity to antidepressants (OR=2.05; 95% CI: 1.49-2.83) as the strongest predictors. Conclusions: This confirms earlier reports associating rapid switching with a more complex clinical course, in particular early emergence of bipolar symptomatology, antidepressant activation, and anxiety comorbidity. These results support a clinical differentiation of bipolar disorder into subtypes based on symptom stability.
AB - Objective: Rapid switching of moods in bipolar disorder has been associated with early age at onset, panic comorbidity, and suicidality. This study aims to confirm these associations and investigate other potential correlates of rapid switching of mood using families from a multisite bipolar linkage study. Methods: The subjects were comprised of 1,143 probands and relatives with diagnosis of bipolar disorder. All subjects were interviewed directly with a standard diagnostic instrument, and all subjects who met criteria for bipolar disorder were asked if their moods had ever switched rapidly. Results: Individuals with rapid mood switching had significantly earlier age at onset (18 versus 21years, p < 0.00001), higher comorbid anxiety (47% versus 26%, p < 0.00001) and substance use disorders (52% versus 42%, p = 0.0006), higher rate of violent behavior (6% versus 3%, p < 0.004), suicidal behavior (46% versus 31%, p < 0.00001), and nonsuicidal self-harm (13% versus 6%, p < 0.0002). Multiple logistic regression analysis found significant net effects on rapid mood switching for early emergence of symptoms [odds ratio (OR) = 0.62; 95% confidence interval (CI): 0.45-0.85]; anxiety comorbidity (OR = 2.31; 95% CI: 1.34-3.98); and hypersensitivity to antidepressants (OR=2.05; 95% CI: 1.49-2.83) as the strongest predictors. Conclusions: This confirms earlier reports associating rapid switching with a more complex clinical course, in particular early emergence of bipolar symptomatology, antidepressant activation, and anxiety comorbidity. These results support a clinical differentiation of bipolar disorder into subtypes based on symptom stability.
KW - Antidepressant activation
KW - Bipolar disorder
KW - Bipolar linkage
KW - Comorbidity
KW - Rapid cycling
KW - Rapid switching of mood
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U2 - 10.1111/j.1399-5618.2008.00600.x
DO - 10.1111/j.1399-5618.2008.00600.x
M3 - Article
C2 - 18657244
AN - SCOPUS:48949120881
SN - 1398-5647
VL - 10
SP - 597
EP - 606
JO - Bipolar Disorders
JF - Bipolar Disorders
IS - 5
ER -