A comparison of the symptomatic profile between two consecutive depressive episodes in patients with bipolar disorder type I.
de Macedo-Soares MB, Brietzke E, da Silva Dias R, Mendonca T, Moreira C, Lafer B. A comparison of the symptomatic profile between two consecutive depressive episodes in patients with bipolar disorder type I.


OBJECTIVE
To compare the variability of patterns of depressive symptoms between two consecutive depressive episodes in patients with bipolar disorder type I.


METHODS
Review of prospectively collected data from 136 subjects of an out-patient bipolar unit from 1997 to 2007. Binomial statistics was used for the analysis of Hamilton Depression Rating Scale (HDRS)-31 items of the first and second episodes, and the correlation of the HDRS-31 item scores of both episodes was determined using the Spearman coefficient.


RESULTS
Ten depressive symptoms showed a significant correlation between index and subsequent episodes: psychological anxiety, somatic anxiety, somatic symptoms, diurnal variation, paranoid symptoms, obsessive and compulsive symptoms, hypersomnia, loss of appetite and helplessness. Only four symptoms were stable in both statistical tests: paranoid symptoms, obsessive-compulsive symptoms, loss of appetite and hypersomnia.


CONCLUSIONS
Paranoid and obsessive-compulsive symptoms, loss of appetite and hypersomnia tended to be found in successive episodes. However, the moderate correlations of the symptoms across two depressive recurrences suggested that clinical presentations in bipolar depression may not be predicted by symptom profiles presented in previous episodes.
1Bipolar Disorder Program, Institute of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil.
Marcia B
MB
De Macedo-Soares
1Bipolar Disorder Program, Institute of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil.
Elisa
E
Brietzke
1Bipolar Disorder Program, Institute of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil.
Rodrigo
R
Da Silva Dias
1Bipolar Disorder Program, Institute of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil.
Tiago
T
Mendonça
1Bipolar Disorder Program, Institute of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil.
Camila
C
Moreira
1Bipolar Disorder Program, Institute of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil.
Beny
B
Lafer