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Am J Psychiatry 1993; 150:901-903
Copyright © 1993 by American Psychiatric Association
Bipolar II: the most common bipolar phenotype?
SG Simpson, SE Folstein, DA Meyers, FJ McMahon, DM Brusco and JR DePaulo Jr
Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD.
OBJECTIVE: The purpose of this study was to compare the pattern of
affective psychopathology in families ascertained for genetic linkage
studies through bipolar I probands to that in families ascertained through
bipolar II probands. METHOD: All available first-degree relatives (N = 266)
of 48 bipolar I and eight bipolar II probands were interviewed with the
Schedule for Affective Disorders and Schizophrenia- -Lifetime Version by
one of two psychiatrists who had attained high interrater reliability for
bipolar II disorder and other diagnoses. RESULTS: Bipolar II disorder was
the most common affective disorder in both family sets. Forty percent of
the 47 first-degree relatives of the bipolar II probands and 22% of the 219
first-degree relatives of the bipolar I probands were diagnosed with
bipolar II disorder. On the other hand, only one bipolar I relative was
found in the bipolar II families. CONCLUSIONS: Bipolar II disorder was the
most prevalent affected phenotype in both bipolar I and bipolar II families
and was the only expressed phenotype in half of the bipolar II families.
This suggests that bipolar II disorder is genetically related to but less
complex than bipolar I disorder. Accurate diagnosis of bipolar II disorder
may be crucial in finding the genetic loci underlying bipolar disorders
generally.
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