Patients who have recovered from bipolar disorder — at least 8 weeks of euthymia — were more likely to experience recurrence of depression or a slower recovery from depression if they had higher levels of irritability, found new research.
Laura D. Yuen and her colleagues at Stanford University assessed 503 outpatients with bipolar I or bipolar II disorder for irritability and recurrence from 2000-2011. Among these, 21% were currently recovered and 30% were currently depressed. At baseline, they assessed the patients with the STEP-BD Affective Disorders Evaluation, and then prospectively with the Clinical Monitoring Form for up to two years of naturalistic treatment during monthly visits.
Nearly twice as many currently depressed patients, 69%, had irritability as did recovered patients (36%). Among recovered patients, 61% of those with irritability and 39% of those without had lifetime anxiety; for current anxiety, those numbers were 58% and 24%, respectively. Irritability was also associated with higher rates of alcohol and substance use disorder, bipolar II disorder, having at least one first-degree relative with a mood disorder, attempting suicide at any point, an earlier age of onset, at least 10 prior episodes, rapid cycling in the previous year, current sadness, anhedonia and euphoria.