Course and Outcome of Bipolar Disorder: Focus on Depressive Aspects
The presence of depressive symptoms dominates the longitudinal course of bipolar disorder (BD) and predicts functional impairment. Despite great progress in understanding the biological basis of BD, the course and outcome of the illness can only be predicted using clinical variables. This chapter summarizes the main factors that predict course and outcome in BD with a focus on depressive symptoms. The natural course of the illness, the impact of the first episode, the impact of the depressive phase, cycle length, onset, age, gender, type of illness, personality traits, temperament, comorbidity, family history, life events, and outcome features will be reviewed. Conceptual models such as disease staging and their prognostic value will also be discussed.
KeywordsBipolar disorder Course Outcome Predictors Mixed depression Clinical diagnosis
Dr. Tohen was a full-time employee at Lilly (1997–2008). He has received honoraria from, or consulted for, Abbott, AstraZeneca, Bristol-Myers Squibb, GlaxoSmithKline, Lilly, Johnson & Johnson, Otsuka, Merck, Sunovion, Forest, Gedeon Richter Plc, Roche, Elan, Alkermes, Lundbeck, Teva, Pamlab, Wyeth, and Wiley Publishing. His spouse was a full-time employee at Lilly (1998–2013). Dr. Escalona has no conflict of interest to disclose, financial or otherwise.
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