Abstract
BackgroundThis study aimed to identify the clinical characteristic of prodromal symptoms in Chinese patients with bipolar disorder (BD), prior to the first affective episode. It further aimed to characterize the prodromal traits between bipolar disorder type I (BD-I) and type II (BD-II).Methods120 individuals with BD-I (n = 92) and BD- II (n = 28) were recruited to the study. Semi-structured interviews were then administered to evaluate prodromal symptoms in patients, within 3 years of BD onset, by using the Bipolar Prodrome Symptom Scale-Retrospective (BPSS-R).ResultsIn the prodromal phase of the first depressive episode, patients with BD-II experienced more prodromal symptoms (p = 0.0028) compared to BD-I. Additionally, more frequent predictors were reported in patients with BD-II than BD-I including educational and occupational dysfunction (p = 0.0023), social isolation (p < 0.001), difficulty making decisions (p = 0.0012), oppositionality (p = 0.012), and suspiciousness/persecutory ideas (p = 0.017). There were also differences in the duration of the precursors. The duration of “weight loss or decrease in appetite” (p = 0.016) lasted longer in patients with BD-I, while “obsessions and compulsions” (p = 0.023) started earlier in patients with BD-II and occurred during the pre-depressive period. The prevalence and duration of each reported prodrome, preceding a first (hypo) manic episode, showed no difference between patients with BD-I and BD-II.ConclusionsSpecific affective, general, or psychotic symptoms occurred prior to both affective episodes. The characteristic of prodromal symptoms were key predictors for later episodes of BD including attenuated mania-like symptoms, subthreshold depressed mood, mood swings/lability, and anxiety. In the pre-depressive state, when compared to BD-II, BD-I presented with more prodromal symptoms in nonspecific dimensions, which indicated the substantial burden of BD-II. In conclusion, this study extends the understanding of the characteristics of prodromes of BD-I and BD-II.
Highlights
This study aimed to identify the clinical characteristic of prodromal symptoms in Chinese patients with bipolar disorder (BD), prior to the first affective episode
Study population Demographic and clinical characteristics of the 120 patients with BD are summarized in Table 1. 76.7% of patients were diagnosed with bipolar disorder type I (BD-I), 23.3% with BD-II. 65% of participants were male and the mean age was 26.5 years old (SD = 10.0)
It is worth noting that 28.6% of BD-II patients in this study reported attenuated mania-like symptoms before full expression of a depressive episode, and that previous studies further supported that depression as associated with hypomanic features increased the risk of later BD [37, 38]
Summary
This study aimed to identify the clinical characteristic of prodromal symptoms in Chinese patients with bipolar disorder (BD), prior to the first affective episode. The milder phases include the emergence of prodromal symptoms, which are symptoms and signs prior to episode onset; these symptoms are considered an ideal intervention state, as patients in early stages are more likely to be responsive to treatment and may need less complex interventions [9, 10]. For this reason, the identification of risk factors, or prodromal symptoms, are important and have received increasing attention from researchers. In a longitudinal study with 107 Dutch adolescent who were bipolar offspring, again subthreshold manic experiences were confirmed to be the strongest predictor of BD conversion and depressive symptoms were considered to be a significant predictor for the onset of the first mood related episode [13]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
