Features Associated With Depressive Predominant Polarity and Early Illness Onset in Patients With Bipolar Disorder
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García Jiménez, Jesús; Gutiérrez Rojas, Luis; Jiménez Fernández, Sara; González Domenech, Pablo José; Carretero Alférez, María Dolores; Gurpegui Fernández De Legaria, ManuelEditorial
FRONTIERS MEDIA SA
Materia
Bipolar disorder Age at onset Disability Polarity predominance Diagnosis delay
Date
2020-11-16Referencia bibliográfica
García-Jiménez, J., Gutiérrez-Rojas, L., Jiménez-Fernández, S., González-Domenech, P. J., Carretero, M. D., & Gurpegui, M. (2020). Features associated with depressive predominant polarity and early illness onset in patients with bipolar disorder. Frontiers in Psychiatry, 11, 1224. [doi: 10.3389/fpsyt.2020.584501]
Abstract
Objective: The aim of this study is to determine the prevalence of three possible
diagnostic specifiers, namely predominant polarity (PP) throughout illness, polarity of the
first episode and early age at onset, in a sample of bipolar disorder (BD) patients and their
association with important socio-demographic, clinical and course-of-illness variables.
Methods: A retrospective and naturalistic study on 108 BD outpatients, who were
classified according to the PP, polarity of the first episode and early age at onset ( 20
years) [vs. late (>20 years)] and were characterized by their demographics, clinical data,
functionality and social support, among others features. After bivariate analyses, those
variables showing certain association (P value < 0.25) with the three dependent variables
were entered in logistic regression backward selection procedures to identify the variables
independently associated with the PP, polarity of the first episode and early age at onset.
Results: The sample consisted of 75 women ad 33 men, 74% with type I BD and 26%
with type II. Around 70% had depressive PP, onset with a depressive episode and onset
after age 20. Depressive PP was independently associated with depressive onset, higher
score on the CGI severity scale and work disability. Onset with depressive episode was
associated with type II BD, longer diagnostic delay and higher score on family disability.
Early age at onset ( 20 years) was associate with younger age, longer diagnostic delay,
presence of ever psychotic symptoms, current use of antipsychotic drugs and higher
social support score.
Conclusions: The results of this study show that BD patients with depressive PP, onset
with depression and early age at onset may represent greater severity, because they are
frequently associated with variables that worsen the prognosis. Our findings match up
with the conclusions of two systematic reviews and we also include a disability factor (at
family and work) that has not been previously reported. This work contributes to the use
of polarity and age at onset in BD patients, as it can become a useful instrument in the
prognostic and therapeutic applications.