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David Baxter PhD

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Bipolar II disorder just as serious as bipolar I disorder
By Liam Davenport
14 November 2007
J Affect Disord 2007; 104: 53-60

Patients with bipolar II disorder experience a high degree of work impairment and frequency of suicide attempts similar to that of bipolar I patients, say US researchers who urge clinicians not to see bipolar II disorder as the "softer" of the two conditions.

A great deal of research has focused on the psychosocial impairment associated with bipolar I disorder and major depressive disorder, but much less on the impact of bipolar II disorder, explain Camilo Ruggero and colleagues from Brown Medical School in Providence, Rhode Island.

To investigate further, the team studied 89 outpatients with bipolar II disorder, 49 with bipolar I disorder, and 1251 with major depressive disorder using the Global Assessment of Functioning (GAF) scale and the Schedule for Affective Disorders. All of the participants were in a major depressive episode.

The severity of current depressive episodes was similar among the groups, but both bipolar groups had younger ages at onset and significantly more past episodes of depression than patients with major depressive disorder.

Meanwhile, bipolar I and II patients had significantly lower GAF scores, higher work impairment ratings, and significantly more suicide attempts than patients with major depressive disorder. In addition, 58% of bipolar I disorder patients had missed more than a year of work, compared with 33% of bipolar II disorder patients and 16% of those with major depressive disorder.

The results, published in the Journal of Affective Disorders, also show that 33% of bipolar I patients had made a serious suicide attempt, compared with 27% of those with bipolar II disorder, and 13% of those in the major depressive disorder group.

However, only work functioning was found to be significantly different among the groups after controlling for the number of hospitalizations and age of illness onset, largely due to a significant difference between bipolar I and major depressive disorder patients.

Noting the high rate of suicide attempts in both bipolar disorder groups, the team says: "This result underscores a major conclusion from the present work, namely that it would be a mistake for clinicians to presume that bipolar II disorder involves less serious consequences compared to bipolar I disorder. It also confirms that bipolar I and II disorder are more impairing than major depressive disorder alone."

Abstract
 
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