Am J Psychiatry 1987; 144:309-315
Copyright © 1987 by American Psychiatric Association
The significance of past mania or hypomania in the course and outcome of major depression
W Coryell, NC Andreasen, J Endicott and M Keller
Patients with primary major depression (N = 372) were followed for 2 years
to determine the prognostic importance of past manic or hypomanic episodes.
While bipolar I and bipolar II patients were more likely to relapse and
bipolar I patients were more likely to attempt suicide, these patients
resembled nonbipolar depressed patients in likelihood of recovery and
psychosocial impairment in various areas. Compared to nonbipolar patients,
those with bipolar I depression were much more likely to develop mania,
while bipolar II patients were more likely to develop hypomania. Cycling
during the index episode predicted a relatively low likelihood of recovery
for bipolar I patients but had no apparent prognostic significance for
patients with bipolar II illness.
