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23 May 2006
Research presented at the 159th Annual Meeting of the American Psychiatric Association in Toronto, Canada, has revealed five predictors for bipolar disorder risk that could aid diagnosis of the condition.
The five factors were anxiety, feelings of people being unfriendly, family history of bipolar disorder, a recent diagnosis of depression, and legal problems.
In all, 43% of patients who reporting having any three of the risk factors also screened positive for bipolar disorder on the Mood disorder Questionnaire (MDQ).
"Bipolar disorder may be difficult for both patients and doctors to identify because the symptoms are often confused with major depression," said Joseph Calabrese, from Case Western Reserve University in Cleveland, Ohio, USA.
"Given the difficulty of diagnosing bipolar disorder, the five predictors identified in this study may help physicians better assess a patient's risk for bipolar disorder, which could lead to more effective treatment."
For the current study, the investigators selected patients attending community and private practice clinics who were unsuccessfully treated with antidepressants. Self-reported information was collected for the participants using the Epidemiologic Studies Depression (CES-D) scale and the patients were screened for bipolar disorder with the MDQ.
Among the 602 patients enrolled in the study, 18.6% screened positive for bipolar disorder on the MDQ. The researchers identified five key variables that they found were associated with bipolar risk: the CES-D item "people were unfriendly" (p<0.001), comorbid anxiety (p<0.002), depression diagnosis within 5 years (p<0.001), family history of bipolar disorder (p<0.010), and legal problems (p<0.026).
For the 41 patients with none of the five risk factors, 2.4% screened positive for bipolar disorder on the MDQ. Among the 103 patients reporting that "people were unfriendly," 31.1% screened positive for bipolar disorder.
The presence of this factor in addition to comorbid anxiety increased the rate of screening positive for bipolar disorder to 35.4%, with the addition of a recent diagnosis of depression onset increasing the likelihood of a positive screen for bipolar disorder to 41.2%. The combination of feeling people were unfriendly and a family history of bipolar disorder was associated with a 75% rate of screening positive for bipolar disorder on the MDQ.
All patients who reported the presence of all five factors screened positive for bipolar disorder on the MDQ, as did 43% of patients who had any three factors.
The researchers conclude that the five factors may prove useful indicators of bipolar disorder risk among patients with major depression from whom antidepressant treatment has failed.
Source: 159th Annual Meeting of the American Psychiatric Association; Toronto, Canada; 20–25 May 2006
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