Psychosocial disability fluctuates in parallel with bipolar symptom changes

December 05, 2005

CHICAGO - With every increase or decrease in depressive symptom severity, there is a corresponding significant and stepwise increase or decrease in psychosocial disability among patients with bipolar disorder, according to a study in the December issue of Archives of General Psychiatry, one of the JAMA/Archives journals.

Bipolar disorder is characterized by cycles of depression and abnormal elation, or mania. It has been found to be associated with increased suicidal behavior, increased health care use and costs, higher unemployment, higher dependence on public assistance, lower annual income, increased work absenteeism owing to illness, decreased work productivity, poorer overall functioning, lower quality of life, and decreased life span, according to background information in the article. Bipolar I disorder (BP-I), which includes episodes of mania, and bipolar II disorder (BP-II), which includes less severe episodes of abnormal mood elevation called hypomania, are dimensional illnesses in which patients experience fluctuating levels of severity of manic and depressive symptoms, interspersed with symptom-free periods.

Lewis L. Judd, M.D., of the University of California, San Diego School of Medicine, and colleagues conducted a study to provide detailed data on psychosocial disability in relation to symptom status during the long-term course of BP-I and BP-II. They analyzed data on 158 patients with BP-I and 133 patients with BP-II who were followed up for an average of 15 years in the National Institute of Mental Health Collaborative Depression Study.

The authors found that symptom severity and psychosocial disability fluctuate together during the course of illness.

"Psychosocial impairment increases significantly with each increment in depressive symptom severity for BP-I and BP-II and with most increments in manic symptom severity for BP-I," they write.

When patients with BP-I or BP-II are asymptomatic, their psychosocial functioning is good, but not as good as that of well controls.

"When patients with BP-I or BP-II have no mood disorder symptoms, their psychosocial functioning normalizes and is rated as good; when they are experiencing subsyndromal depression, psychosocial functioning is between good and fair; when minor depressive or dysthymic symptoms are present, functioning is fair; and when patients have symptoms at the threshold for major depression, functioning is poor," the authors write.

"These findings indicate that the depressive phase of bipolar illness is equal in importance to the manic or hypomanic phase, and they confirm the advantage of studying BP-I and BP-II separately," the authors conclude.
-end-
(Arch Gen Psychiatry. 2005;62:1322-1330. Available pre-embargo to the media at www.jamamedia.org.)

For more information, contact JAMA/Archives Media Relations at 312/464-JAMA (5262) or e-mail mediarelations@jama-archives.org

The JAMA Network Journals

Related Depression Articles from Brightsurf:

Children with social anxiety, maternal history of depression more likely to develop depression
Although researchers have known for decades that depression runs in families, new research from Binghamton University, State University of New York, suggests that children suffering from social anxiety may be at particular risk for depression in the future.

Depression and use of marijuana among US adults
This study examined the association of depression with cannabis use among US adults and the trends for this association from 2005 to 2016.

Maternal depression increases odds of depression in offspring, study shows
Depression in mothers during and after pregnancy increased the odds of depression in offspring during adolescence and adulthood by 70%.

Targeting depression: Researchers ID symptom-specific targets for treatment of depression
For the first time, physician-scientists at Beth Israel Deaconess Medical Center have identified two clusters of depressive symptoms that responded to two distinct neuroanatomical treatment targets in patients who underwent transcranial magnetic brain stimulation (TMS) for treatment of depression.

A biological mechanism for depression
Researchers report that in depressed individuals there are increased amounts of an unmodified structural protein, called tubulin, in lipid rafts compared with non-depressed individuals.

Depression in adults who are overweight or obese
In an analysis of primary care records of 519,513 UK adults who were overweight or obese between 2000-2016 and followed up until 2019, the incidence of new cases of depression was 92 per 10,000 people per year.

Why stress doesn't always cause depression
Rats susceptible to anhedonia, a core symptom of depression, possess more serotonin neurons after being exposed to chronic stress, but the effect can be reversed through amygdala activation, according to new research in JNeurosci.

Which comes first: Smartphone dependency or depression?
New research suggests a person's reliance on his or her smartphone predicts greater loneliness and depressive symptoms, as opposed to the other way around.

Depression breakthrough
Major depressive disorder -- referred to colloquially as the 'black dog' -- has been identified as a genetic cause for 20 distinct diseases, providing vital information to help detect and manage high rates of physical illnesses in people diagnosed with depression.

CPAP provides relief from depression
Researchers have found that continuous positive airway pressure (CPAP) treatment of obstructive sleep apnea (OSA) can improve depression symptoms in patients suffering from cardiovascular diseases.

Read More: Depression News and Depression Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.