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. 2024 Aug 1;25(4):472-479.
doi: 10.5152/alphapsychiatry.2024.241474. eCollection 2024 Aug.

Characterization of Bipolar Disorder I and II: Clinical Features, Comorbidities, and Pharmacological Pattern

Andrea Aguglia  1   2 , Gabriele Giacomini  2 , Clio F De Michiel  1 , Nicolò Garbarino  1 , Alessio Lechiara  1 , Caterina Magni  1 , Matteo Meinero  1 , Edoardo Verrina  1 , Alessandra Costanza  3   4   5 , Andrea Amerio  1   2 , Mario Amore  1 , Gianluca Serafini  1   2
Affiliations

Characterization of Bipolar Disorder I and II: Clinical Features, Comorbidities, and Pharmacological Pattern

Andrea Aguglia et al. Alpha Psychiatry. .

Abstract

Objective: Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition provides precise diagnostic criteria to differentiate between bipolar disorder (BD) type I and II; nevertheless, it can be challenging to come up with the right diagnosis. The aim of this study is to evaluate the sociodemographic differences, clinical features, comorbidities, and pharmacological pattern between patients with BD type I and II.

Methods: A total of 680 patients with BD type I and II were consecutively recruited to our psychiatry department. A semi-structured interview was used to collect several information.

Results: Patients with BD type I were mostly males, single, with a lower current age, and unemployed compared to patients with BD type II. Furthermore, patients with BD type I showed an earlier age at onset and a significant higher prevalence of psychotic and residual symptoms, a higher number of hospitalizations, and involuntary admissions. On the other hand, patients with BD type II were associated with a significant higher prevalence of lifetime suicide attempts, psychiatric comorbidities, and use of alcohol. Finally, antidepressant drugs were prescribed more often to patients with BD type II, while antipsychotics and mood stabilizers were mostly prescribed in patients with BD type I.

Conclusion: the differentiation of the 2 nosologic bipolar diagnosis is in line with the current scientific interest, confirming the existence of a markedly different profile between BD type I and II. This differentiation could reduce the heterogeneity of bipolar presentation in research, optimize clinical assessment, and increase the interest in developing more precise and individualized therapeutic strategies, also implementing psychosocial therapies.

Keywords: Bipolar disorder; affective disorder; comorbidity; psychosis; suicidal behavior.

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Conflict of interest statement

Declaration of Interests: The authors have no conflicts of interest to declare. G.S. is serving as one of the Editorial Board members of this journal. We declare that G.S. had no involvement in the peer review of this article and has no access to information regarding its peer review.

Figures

Figure 1.
Figure 1.
Comorbidities of the total sample and comparison according to the diagnosis of bipolar disorder. * P <.05
Figure 2.
Figure 2.
Pharmacological treatment of the total sample and comparison according to the diagnosis of bipolar disorder. * P <.05
See this image and copyright information in PMC

References

    1. Hernandorena CV, Baldessarini RJ, Tondo L, Vázquez GH. Status of Type II vs. Type I bipolar disorder: systematic Review with Meta-Analyses. Harv Rev Psychiatry. 2023;31(4):173 182. (10.1097/HRP.0000000000000371) - DOI - PubMed
    1. Ghaemi SN. Bipolar spectrum: a review of the concept and a vision for the future. Psychiatry Investig. 2013;10(3):218 224. (10.4306/pi.2013.10.3.218) - DOI - PMC - PubMed
    1. Zivanovic O, Nedic A. Kraepelin’s concept of manic-depressive insanity: one hundred years later. J Affect Disord. 2012;137(1-3):15 24. (10.1016/j.jad.2011.03.032) - DOI - PubMed
    1. Anderson IM, Haddad PM, Scott J. Bipolar disorder. BMJ. 2012;345:e8508. (10.1136/bmj.e8508) - DOI - PubMed
    1. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 3rd ed. Washington: American Psychiatric Publishing, 1980.

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