Am J Psychiatry 1976; 133:905-908
Copyright © 1976 by American Psychiatric Association
The course of development of mania in patients with recurrent depression
DL Dunner, JL Fleiss and RR Fieve
The authors attempted to assess the extent to which bipolar patients are
misdiagnosed as unipolar by evaluating the development of mania in patients
who had recognized bipolar illness and by means of follow-up data on
patients who had recurrent depressions. Mania occurred early in the course
of bipolar illness: almost 80% of the bipolar patients were initially
hospitalized for mania. Follow-up data and theoretically based calculations
suggest that the chance of a patient with recurrent depressions becoming
bipolar is about 5%. Based on these findings, the authors make suggestions
for the classification of unipolar patients.
