Empirical typology of bipolar I mood episodes.
BACKGROUND
Much remains unknown about the phenomenology of bipolar I disorder.


OBJECTIVE
To determine the type of bipolar I mood episodes that occur over time, and their relative frequency.


METHODS
A total of 219 individuals with Research Diagnostic Criteria bipolar I disorder were prospectively followed for up to 25 years (median 20 years). Psychopathology was assessed with the Longitudinal Interval Follow-up Evaluation.


RESULTS
Overall, 1208 mood episodes were prospectively observed. The episodes were empirically classified as follows: major depression, 30.9% (n = 373); minor depression, 13.0% (n = 157); mania, 20.4% (n = 246); hypomania, 10.4% (n = 126); cycling, 17.3% (n = 210); cycling plus mixed state, 7.8% (n = 94); and mixed, 0.2% (n = 2).


CONCLUSIONS
Cycling episodes constituted 25% of all episodes. Work groups revising ICD-10 and DSM-IV should add a category for bipolar I cycling episode.
Solomon
David A
DA
Department of Psychiatry, Rhode Island Hospital, 593 Eddy Street, Providence, Rhode Island 02903-4970, USA. DASolomon@Lifespan.org
Leon
Andrew C
AC
Endicott
Jean
J
Coryell
William H
WH
Li
Chunshan
C
Fiedorowicz
Jess G
JG
Keller
Martin B
MB
D000293:Adolescent; D000328:Adult; D000339:Affect / Q000187:drug effects; D000368:Aged; D000369:Aged, 80 and over; D000928:Antidepressive Agents / Q000627:therapeutic use; D001714:Bipolar Disorder / Q000188:drug therapy / Q000453:epidemiology / Q000523:psychology*; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D038801:International Classification of Diseases; D008297:Male; D008875:Middle Aged; D010641:Phenotype; D011446:Prospective Studies; D013000:Psychiatric Somatic Therapies; D011569:Psychiatric Status Rating Scales; D014481:United States / Q000453:epidemiology; D055815:Young Adult
D000928:Antidepressive Agents