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The British Journal of Psychiatry (2005) 187: 87-88
© 2005 The Royal College of Psychiatrists

SHORT REPORT

`Bipolarity' in bipolar disorder: distribution of manic and depressive symptoms in a treated population

MARK S. BAUER, MD

Veterans Affairs Medical Center and Brown University, Providence, Rhode Island

GREGORY E. SIMON, MD and EVETTE LUDMAN, PhD

Group Health Cooperative and University of Washington, Seattle

JURGEN UNÜTZER, MD

University of Washington, Seattle, Washington, USA

Correspondence: Dr Mark S.Bauer, VAMC-116R, 830 Chalkstone Avenue, Providence, RI 02908-4799, USA. Tel: +1 401 273 7100, ext. 38631; fax: +1 4 01 457 3311; e-mail: mark____bauer{at}brown.edu

Declaration of interest None. Funding detailed in Acknowledgements.

ABSTRACT

Cross-sectional analysis of 441 individuals with bipolar disorder treated at a US health maintenance organisation investigated the distribution of manic and depressive symptomsin that illness. Clinically significant depressive symptoms occurred in 94.1% of those with (hypo)mania, while 70.1% in a depressive episode had clinically significant manic symptoms. DSM-unrecognised depression-plus-hypomania was over twice as prevalent as DSM-recognised mixed episodes. Depressive symptoms were unimodally distributed in (hypo)mania. Depressive and manic symptoms were positively, not inversely, correlated, and their co-occurrence was associated with worse quality of life. Implications for the DSM and ICD nosological systems are discussed.




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