Table 4.
Prodromes most cited in the literature that are identified by adult patients with BD. a
| Initial prodromes | Relapse prodromes | ||
|---|---|---|---|
| Manic/hypomanic episodes | Depressive episodes | Manic/hypomanic episodes | Depressive episodes |
| Overly talkative (k = 3) | Mood lability/mood swings (k = 3) | Sleep disturbances/decreased need for sleep (k = 13) | Low in energy-tired (k = 8) |
| Racing thoughts (k = 3) | Insomnia (k = 3) | Elevated mood (k = 10) | Feeling anxious/restlessness (k = 6) |
| Irritability (k = 3) | Depressed mood (k = 3) | More talkative than usual (k = 10) | Weight loss or poor appetite (k = 6) |
| Mood elevation (k = 3) | Tiredness or lack of energy (k = 3) | Increased energy/more goal-directed behavior (k = 9) | Depressed mood (k = 6) |
| Mood lability/mood swings (k = 3) | Decreased school or work functioning (k = 3) | Irritable (k = 9) | Irritable (k = 5) |
| Reckless or dangerous behavior (k = 3) | Feeling worthless or guilty (k = 3) | Thoughts start to race (k = 8) | Difficulty concentrating (k = 5) |
| Thinking about suicide (k = 3) | Increased self-esteem (k = 8) | Insomnia (k = 5) | |
| Difficulty concentrating (k = 7) | Negative thinking/worrying a lot (k = 5) | ||
| Feeling anxious/restlessness (k = 6) | Feeling very guilty (k = 4) | ||
| Strong interest in sex (k = 6) | Loss of interest (k = 4) | ||
| Increase in activity (k = 6) | Hypersomnia (k = 4) | ||
| Spending too much (k = 5) | |||
| Unusual thought content (k = 5) | |||
k = number of studies.
a
The following relapse prodromes of mania: overactivity, does not need much sleep, irritability, elation, and concentration difficulty, identified by Sahoo et al. [32] have not been included in this table since they were derived from a combination of patients’ and relatives’ information.