302016Aug

Irritability in Recovered Bipolar Disorder Patients Linked to Greater Morbidity, Depression Recurrence

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.

Read the full at http://www.psychiatryadvisor.com/bipolar-disorder/irritability-in-recovered-bipolar-disorder-patients-and-depression/article/517666/