title: Long-term morbidity in bipolar-I, bipolar-II, and unipolar major depressive disorders.
abstract: BACKGROUND
  Long-term symptomatic status in persons with major depressive and bipolar disorders treated clinically is not well established, although mood disorders are leading causes of disability worldwide.
  
  
  OBJECTIVE
  To pool data on long-term morbidity, by type and as a proportion of time-at-risk, based on published studies and previously unreported data.
  
  
  METHODS
  We carried out systematic, computerized literature searches for information on percentage of time in specific morbid states in persons treated clinically and diagnosed with recurrent major depressive or bipolar I or II disorders, and incorporated new data from one of our centers.
  
  
  RESULTS
  We analyzed data from 25 samples involving 2479 unipolar depressive and 3936 bipolar disorder subjects (total N=6415) treated clinically for 9.4 years. Proportions of time ill were surprisingly and similarly high across diagnoses: unipolar depressive (46.0%), bipolar I (43.7%), and bipolar II (43.2%) disorders, and morbidity was predominantly depressive: unipolar (100%), bipolar-II (81.2%), bipolar-I (69.6%). Percent-time-ill did not differ between UP and BD subjects, but declined significantly with longer exposure times.
  
  
  CONCLUSIONS
  The findings indicate that depressive components of all major affective disorders accounted for 86% of the 43-46% of time in affective morbidity that occurred despite availability of effective treatments. These results encourage redoubled efforts to improve treatments for depression and adherence to their long-term use.
authors: Department of Psychiatry, Harvard Medical School, Boston, MA, United States; International Consortium for Mood & Psychotic Disorder Research, Mailman Research Center, Belmont, MA, United States; NESMOS Department of Psychiatry, Sant׳Andrea Medical Center, Sapienza University of Rome, Italy.
authors: Alberto
authors: A
authors: Forte
authors: Department of Psychiatry, Harvard Medical School, Boston, MA, United States; International Consortium for Mood & Psychotic Disorder Research, Mailman Research Center, Belmont, MA, United States. Electronic address: rbaldessarini@mclean.harvard.edu.
authors: Ross J
authors: RJ
authors: Baldessarini
authors: Department of Psychiatry, Harvard Medical School, Boston, MA, United States; International Consortium for Mood & Psychotic Disorder Research, Mailman Research Center, Belmont, MA, United States; Lucio Bini Mood Disorders Center, Cagliari, Italy; Lucio Bini Mood Disorders Center, Rome, Italy.
authors: Leonardo
authors: L
authors: Tondo
authors: International Consortium for Mood & Psychotic Disorder Research, Mailman Research Center, Belmont, MA, United States; Department of Neuroscience, Palermo University, Buenos Aires, Argentina.
authors: Gustavo H
authors: GH
authors: Vázquez
authors: NESMOS Department of Psychiatry, Sant׳Andrea Medical Center, Sapienza University of Rome, Italy.
authors: Maurizio
authors: M
authors: Pompili
authors: NESMOS Department of Psychiatry, Sant׳Andrea Medical Center, Sapienza University of Rome, Italy.
authors: Paolo
authors: P
authors: Girardi
mesh_terms: D001714:Bipolar Disorder / Q000453:epidemiology*; D003865:Major Depressive Disorder / Q000453:epidemiology*; D006801:Humans; D009017:Morbidity
keywords: Bipolar I; Bipolar II; Long-term; Major depression; Morbidity; Percent-time ill