Table 2.
Reported Prevalence and Duration of Prodromal Symptoms between Patients with BD-I and BD-II Prior to First Depressive Episode
| Prodromal Symptom characteristics | Prevalence (Yes) | Duration (Weeks) | ||||||||
|---|---|---|---|---|---|---|---|---|---|---|
| BD-I(n = 92) | BD-II(n = 28) | P value | BD-I(n = 92) | BD-II(n = 28) | P value | |||||
| N | % | N | % | Mean | SD | Mean | SD | |||
| Mania Symptom Index | ||||||||||
| Extremely energetic/active | 3 | 3.3 | 1 | 3.6 | 1.00 a | 8.6 | 0.0 | 0.0 | 0.0 | n.a. |
| Overly cheerful, happy, on top of the world | 3 | 3.3 | 0 | 0.0 | 1.00a | 10.1 | 5.0 | 0.0 | 0.0 | n.a. |
| Racing thoughts | 2 | 2.2 | 0 | 0.0 | 1.00 a | 32.4 | 27.5 | 25.9 | 0.0 | 1.00 |
| Overly talkative | 3 | 3.3 | 3 | 10.7 | 0.14 a | 13.0 | 0.0 | 25.9 | 24.4 | 1.00 |
| Decreased need for sleep | 2 | 2.2 | 2 | 7.1 | 0.23 a | 0.0 | 0.0 | 0.0 | 0.0 | n.a. |
| Irritability or anger | 11 | 12.0 | 6 | 21.4 | 0.22 | 11.7 | 9.1 | 5.4 | 3.1 | 0.14 |
| Overly self-confident | 1 | 1.1 | 1 | 3.6 | 0.41 | 17.3 | 0.0 | 43.2 | 0.0 | 0.19 |
| Physical agitated | 2 | 2.2 | 0 | 0.0 | 1.00a | 10.8 | 10.3 | 4.3 | 0.0 | 0.062 |
| Increased sexual energy | 0 | 0.0 | 1 | 3.6 | 0.23 a | 4.3 | 0.0 | 43.2 | 0.0 | n.a. |
| Reckless or dangerous behaviors | 0 | 0.0 | 0 | 0.0 | n.a. | 0.0 | 0.0 | 0.0 | 0.0 | n.a. |
| Risky sexual behavior | 0 | 0.0 | 0 | 0.0 | n.a. | 0.0 | 0.0 | 0.0 | 0.0 | n.a. |
| Trouble concentrating | 22 | 23.9 | 12 | 42.9 | 0.05 | 13.9 | 12.9 | 11.8 | 14.9 | 0.52 |
| Mania Index total | 29 | 31.5 | 16 | 57.1 | 0.014* | |||||
| Depression Symptom Index | ||||||||||
| Depressed mood | 37 | 40.2 | 13 | 46.4 | 0.56 | 14.4 | 14.0 | 7.0 | 3.8 | 0.062 |
| Tiredness or lack of energy | 24 | 26.1 | 10 | 35.7 | 0.32 | 12.3 | 10.2 | 6.7 | 3.0 | 0.11 |
| Reduction of enjoyment/ interest | 28 | 30.4 | 9 | 32.1 | 0.90 | 15.4 | 16.7 | 7.9 | 6.6 | 0.21 |
| Trouble concentrating | 22 | 23.9 | 12 | 42.9 | 0.05 | 13.9 | 12.9 | 11.8 | 14.9 | 0.52 |
| Insomnia | 20 | 21.7 | 11 | 39.3 | 0.06 | 15.4 | 14.9 | 12.2 | 13.6 | 0.55 |
| Feeling of worthlessness or guilt | 11 | 12.0 | 7 | 25.0 | 0.13a | 9.6 | 7.5 | 9.2 | 7.5 | 1.00 |
| Weight loss or decrease in appetite | 8 | 8.7 | 5 | 17.9 | 0.18 | 17.3 | 16.2 | 5.6 | 3.3 | 0.016* |
| Physically slowed down | 6 | 6.5 | 5 | 17.9 | 0.13 a | 9.2 | 9.1 | 4.3 | 0.0 | 0.36 |
| Thinking about suicide | 6 | 6.5 | 3 | 10.7 | 0.43 | 8.0 | 8.1 | 10.8 | 3.1 | 0.15 |
| Sleeping too much | 8 | 8.7 | 5 | 17.9 | 0.18 | 6.5 | 4.3 | 17.3 | 23.1 | 0.51 |
| Attempting suicide | 3 | 3.3 | 2 | 7.1 | 0.33a | 4.3 | 0.0 | 4.3 | 0.0 | 1.00 |
| Weight gain or increasing in appetite | 4 | 4.4 | 1 | 3.6 | 1.00 a | 23.3 | 18.0 | 23.8 | 27.5 | 0.85 |
| Depression Index Total | 49 | 53.3 | 23 | 82.1 | 0.0063** | |||||
| General Symptom Index | ||||||||||
| Educational and occupational dysfunction | 19 | 20.7 | 14 | 50.0 | 0.0023** | 9.7 | 8.2 | 4.3 | 0.0 | 0.27 |
| Anxiety or nervousness | 24 | 26.1 | 11 | 39.3 | 0.18 | 13.2 | 12.6 | 11.8 | 13.8 | 0.74 |
| Social Isolation | 14 | 15.2 | 15 | 53.6 | < 0.001*** | 4.3 | 0.0 | 0.0 | 0.0 | n.a. |
| Frequent mood swings/lability | 10 | 10/9 | 5 | 17.9 | 0.34 a | 14.4 | 15.4 | 6.5 | 4.6 | 0.054 |
| Difficulty making decisions | 6 | 6.5 | 9 | 32.1 | 0.0012 **a | 11.5 | 9.9 | 11.0 | 12.6 | 0.88 |
| Obsessions and compulsions | 5 | 5.4 | 5 | 17.9 | 0.05 a | 6.9 | 3.9 | 21.6 | 14.5 | 0.023* |
| Losing temper frequently or trouble controlling anger | 9 | 9.8 | 2 | 7.1 | 1.00a | 11.5 | 8.5 | 8.6 | 7.5 | 0.4962 |
| Day/night sleep reversal | 3 | 3.3 | 2 | 7.1 | 0.33a | 13.7 | 15.3 | 25.9 | 24.1 | 0.3452 |
| Self-injurious behavior (no intent to kill self) | 3 | 3.3 | 2 | 7.1 | 0.33 | 8.6 | 6.1 | 5.8 | 2.5 | 0.5541 |
| Oppositionality | 0 | 0.0 | 3 | 10.7 | 0.012 a | 5.8 | 2.5 | 4.3 | 0.0 | |
| Giddy, clownish | 2 | 2.2 | 1 | 3.6 | 0.55 a | 0.0 | 0.0 | 19.4 | 21.4 | n.a. |
| Increased creativity | 3 | 3.3 | 1 | 3.6 | 1.00 a | 4.3 | 0.0 | 8.6 | 0.0 | n.a. |
| General Index Total | 39 | 42.4 | 22 | 78.6 | 0.0008*** | |||||
| Psychosis Symptom Index | ||||||||||
| Suspiciousness/persecutory ideas | 3 | 3.3 | 5 | 17.9 | 0.017* | 4.3 | 0.0 | 7.6 | 6.5 | n.a. |
| Strange or unusual ideas | 5 | 5.4 | 1 | 3.6 | 1.00 a | 30.3 | 30.6 | 23.8 | 27.5 | |
| Difficulty thinking or communicating clearly | 17 | 18.5 | 7 | 25.0 | 0.45 | 10.9 | 8.6 | 5.9 | 4.0 | |
| Hallucinations | 3 | 3.3 | 0 | 0.0 | 1.00a | 0.0 | 0.0 | 0.0 | 0.0 | n.a. |
| Psychosis Index Total | 21 | 22.8 | 11 | 39.3 | 0.085 | |||||
| BPSS-R Total | 50 | 54.4 | 24 | 85.7 | 0.0028 | |||||
Abbreviations: BD, Bipolar Disorder; SD, Standard Deviation; BPSS-R, Bipolar Prodrome Symptom Scale-Retrospective
n.a. = not applicable
*P < 0.05 **P < 0.01 ***P < 0.001
a: Fisher exact test