title: Bipolar II disorder: personality and outcome in two clinical samples.
abstract: OBJECTIVE
  To compare the personality traits and disorders of patients with bipolar II disorder and major depression and to examine the impact on treatment outcome of a bipolar II diagnosis.
  
  
  METHODS
  Patients from two clinical trials, a depressive sample (n = 195, 10% bipolar II) and a bulimic sample (n = 135, 16% bipolar II), were assessed for personality traits using DSM-IV criteria. Patients were randomised to treatments (fluoxetine or nortriptyline for depressive sample; cognitive behaviour therapy for bulimic sample) and followed for 3 years (depressive sample) or 5 years (bulimic sample) to assess the impact on outcome of a bipolar II diagnosis.
  
  
  RESULTS
  Bipolar II patients were assessed as having more borderline, histrionic and schizotypal personality traits than patients with major depression. A baseline bipolar II diagnosis did not impact negatively on treatment outcome, and less than 5% of bipolar II patients developed bipolar I disorder during follow up.
  
  
  CONCLUSIONS
  The low rate of conversion of bipolar II to bipolar I disorder and the lack of adverse impact of the diagnosis on outcome, questions the need for antimanic or mood stabiliser medication in most bipolar II patients.
authors.affiliation: Department of Psychological Medicine, Christchurch School of Medicine and Health Sciences, Christchurch, New Zealand. peter.joyce@chmeds.ac.nz
authors.forename: Peter R
authors.initials: PR
authors.lastname: Joyce
authors.forename: Suzanne E
authors.initials: SE
authors.lastname: Luty
authors.forename: Janice M
authors.initials: JM
authors.lastname: McKenzie
authors.forename: Roger T
authors.initials: RT
authors.lastname: Mulder
authors.forename: Virginia V
authors.initials: VV
authors.lastname: McIntosh
authors.forename: Frances A
authors.initials: FA
authors.lastname: Carter
authors.forename: Cynthia M
authors.initials: CM
authors.lastname: Bulik
authors.forename: Patrick F
authors.initials: PF
authors.lastname: Sullivan
mesh_terms: D018759:Adrenergic Uptake Inhibitors / Q000627:therapeutic use*; D000328:Adult; D001714:Bipolar Disorder / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology*; D002032:Bulimia / Q000453:epidemiology* / Q000628:therapy*; D015928:Cognitive Behavioral Therapy / Q000379:methods; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology*; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D005473:Fluoxetine / Q000627:therapeutic use*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009661:Nortriptyline / Q000627:therapeutic use*; D010554:Personality Disorders / Q000175:diagnosis / Q000453:epidemiology*; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use*
chemical_list: D018759:Adrenergic Uptake Inhibitors; D005473:Fluoxetine; D009661:Nortriptyline; D017367:Selective Serotonin Reuptake Inhibitors