title: A polyepisodic course in bipolar illness: possible clinical relationships.
abstract: Using archival data, we conducted a systematic study of consecutive admissions of bipolar patients and found that an early age of onset, a subacute onset, a family history of bipolarity, and the administration of electroconvulsive therapy (ECT) during an index episode were individually associated with a polyepisodic course of illness (three to nine or more episodes) during a period of observation which included onset of illness, index admission, and a period of follow-up. The family history of biopolarity which seems to predispose to multiple episodes suggests that what may be transmitted may not necessarily be a bipolar illness but possibly an illness with many episodes, thus increasing the likelihood of occurrence of a manic episode.
authors.affiliation: Department of Psychiatry, University of Iowa College of Medicine, Iowa City 52242.
authors.forename: G
authors.initials: G
authors.lastname: Winokur
authors.forename: A
authors.initials: A
authors.lastname: Kadrmas
mesh_terms: D000367:Age Factors; D001714:Bipolar Disorder / Q000235:genetics* / Q000503:physiopathology / Q000628:therapy; D004565:Electroconvulsive Therapy; D005260:Female; D006801:Humans; D008297:Male; D015233:Models, Statistical