Researchers Identify Seven Risk Factors for Emergence of Bipolar Disorder

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New research published in the Journal of Affective Disorders suggests there are seven factors which predict which patients initially diagnosed with depression will later fit the criteria for bipolar disorder.

According to the data gathered from 2,146 patients initially presented with a first episode of major depression, having at least four previous depressive episodes, suicidal acts, cyclothymic temperament, family history of bipolar disorder, substance abuse, younger age at onset and male gender all significantly and independently differentiate bipolar from unipolar disorders.

Of the participants, 642 (29.9%) were diagnosed with bipolar disorder after an average of 13 years, while 1,504 (70.1%) were diagnosed with major depressive disorder.

Only four of the factors identified by the research team led by Leonardo Tondo (McLean Hospital, Belmont, Massachusetts) can typically be assessed at the time of the initial depressive episode. Those factors are cyclothymic temperament, family history of bipolar disorder, age at onset, and male gender, and may be “of particular importance for prognosis and treatment.”

In their report, Tondo and co-authors suggest “the presence of multiple predictive factors associated selectively with bipolar disorder should raise suspicion about the risk of emergence of spontaneous or drug-associated mania, even with a current diagnosis of unipolar major depression.”

They conclude, “It is important to ascertain diagnoses and formulate prognoses early so as to guide planning for optimal clinical care of mood-disorder patients, including timely consideration of mood-stabilizing medicines and cautious use of antidepressants, so as to limit risk of unanticipated and potentially dangerous mood-switching.”

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