Table 3.
Reported Prevalence and Duration of Prodromal Symptoms Between Patients with BD-I and BD-II Prior to the First Mania/ Hypomania Episode
| Prodromal symptom characteristics | Prevalence (Yes/No) | 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 | 32 | 34.8 | 11 | 39.3 | 0.66 | 8 | 5.8 | 4.9 | 3.6 | 0.10 |
| Overly cheerful, happy, on top of the world | 27 | 29.4 | 8 | 28.6 | 0.94 | 13.9 | 21.1 | 8.6 | 8.6 | 0.38 |
| Racing thoughts | 24 | 26.1 | 6 | 21.4 | 0.62 | 8.3 | 6.7 | 4.3 | 3.5 | 0.24 |
| Overly talkative | 32 | 34.8 | 9 | 32.1 | 0.80 | 6.5 | 4 | 8.6 | 8.6 | 0.82 |
| Decreased need for sleep | 18 | 19.6 | 5 | 17.9 | 0.84 | 13.7 | 28.5 | 5.2 | 4.7 | 0.45 |
| Irritability or anger | 21 | 22.8 | 6 | 21.4 | 0.88 | 15.8 | 25.4 | 7.2 | 5.2 | 0.54 |
| Overly self-confident | 13 | 14.1 | 3 | 10.7 | 0.64 | 21.6 | 50.3 | 15.6 | 20.9 | 0.53 |
| Physical agitated | 9 | 9.8 | 3 | 10.7 | 0.89 | 13 | 9.7 | 6.1 | 4.9 | 0.18 |
| Increased sexual energy | 3 | 3.3 | 3 | 10.7 | 0.14 | 5.8 | 3.5 | 6.5 | 7.5 | 0.74 |
| Reckless or dangerous behaviors | 10 | 10.9 | 3 | 10.7 | 1.00a | 21.6 | 40.4 | 10.1 | 10.9 | 0.90 |
| Risky sexual behavior | 3 | 3.3 | 3 | 10.7 | 0.14a | 2.2 | 3.1 | 10.8 | 15.3 | 0.68 |
| Trouble concentrating | 14 | 15.2 | 4 | 14.3 | 1.00a | 17.3 | 14 | 8.6 | 6.1 | 0.22 |
| Mania Index total | 65 | 70.7 | 18 | 64.3 | 0.52 | 15.8 | 28.6 | 12.2 | 13.8 | 0.83 |
| Depression Symptom Index | ||||||||||
| Depressed mood | 7 | 7.6 | 4 | 14.3 | 0.28a | 30.8 | 36.7 | 10.4 | 4.9 | 0.37 |
| Tiredness or lack of energy | 6 | 6.5 | 2 | 7.1 | 1.00a | 15.6 | 12.4 | 8.6 | 4.3 | 0.55 |
| Reduction of enjoyment/ interest | 6 | 6.5 | 1 | 3.6 | 1.00a | 25.2 | 22.1 | 4.3 | 6.1 | 0.18 |
| Trouble concentrating | 14 | 15.2 | 4 | 14.3 | 1.00a | 17.3 | 14 | 8.6 | 6.1 | 0.22 |
| Insomnia | 18 | 19.6 | 3 | 10.7 | 0.40a | 11.7 | 12.5 | 5.8 | 6.6 | 0.35 |
| Feeling of worthless or guilty | 5 | 5.4 | 2 | 7.1 | 0.66 a | 10.4 | 10.8 | 6.5 | 2.5 | 1.00 |
| Weight loss or decrease in appetite | 5 | 5.4 | 3 | 10.7 | 0.39 a | 17.3 | 21.8 | 8.6 | 5.3 | 0.91 |
| Physically slowed down | 3 | 3.3 | 0 | 0.0 | 1.00 a | 18.7 | 28.8 | – | – | n.a. |
| Thinking about suicide | 1 | 1.1 | 1 | 3.6 | 0.41a | 10.1 | 13.9 | 4.3 | 6.1 | 0.77 |
| Sleeping too much | 5 | 5.4 | 1 | 3.6 | 1.00a | 30.3 | 49 | 10.1 | 13.9 | 0.46 |
| Attempting suicide | 1 | 1.1 | 0 | 0.0 | 1.00a | 2.2 | 3.1 | – | – | n.a. |
| Weight gain or increasing in appetite | 5 | 5.4 | 4 | 14.3 | 0.21 | 16.2 | 24 | 16.2 | 24 | 1.00 |
| Depression Index Total | 33 | 35.9 | 12 | 42.9 | 0.50 | 20.3 | 28.1 | 14.4 | 14.7 | 0.95 |
| General Symptom Index | ||||||||||
| Educational and occupational dysfunction | 20 | 21.7 | 2 | 7.1 | 0.081 | 18.5 | 15.6 | 8.6 | 6.1 | 0.37 |
| Anxiety or nervousness | 16 | 17.4 | 5 | 17.9 | 1.00a | 38.9 | 50.6 | 13.8 | 16.8 | 0.23 |
| Social isolation | 12 | 13.0 | 1 | 3.6 | 0.30a | 21.2 | 17.9 | 6.9 | 3.9 | 0.078 |
| Frequent mood swings/lability | 28 | 30.4 | 6 | 21.4 | 0.35 | 17.7 | 29.9 | 11.7 | 11.4 | 0.86 |
| Difficulty making decisions | 4 | 4.4 | 3 | 10.7 | 0.35a | 31.3 | 48.4 | 6.1 | 3.9 | 0.45 |
| Obsessions and compulsions | 7 | 7.6 | 2 | 7.1 | 1.00a | 26.5 | 39.7 | 6.5 | 5.6 | 0.44 |
| Losing temper frequently or trouble controlling anger | 30 | 32.6 | 4 | 14.3 | 0.060 | 12.3 | 23.6 | 7.2 | 4.3 | 0.83 |
| Day/night sleep reversal | 5 | 5.4 | 1 | 3.6 | 1.00a | 11.7 | 17.9 | 10.1 | 13.9 | 0.72 |
| Self-injurious behavior (no intent to kill self) | 0 | 0.0 | 0 | 0.0 | n.a | 79.9 | 106.9 | 4.3 | 6.1 | 0.44 |
| Oppositionality | 15 | 16.3 | 3 | 10.7 | 0.58a | 22.6 | 31.1 | 5.8 | 6.6 | 0.13 |
| Giddy, clownish | 15 | 16.3 | 3 | 10.7 | 0.56a | 10.8 | 14.9 | 7.2 | 6.6 | 0.93 |
| Increased creativity | 12 | 13.0 | 5 | 17.9 | 0.54a | 21.1 | 50.5 | 12.1 | 17.7 | 0.82 |
| VGeneral Index Total | 62 | 67.4 | 17 | 60.7 | 0.51 | 20.1 | 35.6 | 14.5 | 14.4 | 0.70 |
| Psychosis Symptom Index | ||||||||||
| Suspiciousness/persecutory ideas | 20 | 21.7 | 4 | 14.3 | 0.39 | 13.9 | 26.3 | 4.3 | 3.1 | 0.22 |
| Strange or unusual ideas | 21 | 22.8 | 4 | 14.3 | 0.33 | 20.7 | 30 | 5.8 | 5 | 0.23 |
| Difficulty thinking or communicating clearly | 9 | 9.8 | 3 | 10.7 | 1.00a | 18 | 17.2 | 0 | . | n.a. |
| Hallucinations | 5 | 5.4 | 1 | 3.6 | 1.00a | 10.1 | 9 | 2.2 | 3.1 | 0.37 |
| Psychosis Index Total | 32 | 34.8 | 7 | 25.0 | 0.33 | 16.8 | 24.7 | 5.0 | 3.3 | 0.11 |
| BPSS-R Total | 75 | 81.5 | 22 | 78.6 | 0.73 | 18.4 | 32.6 | 15.7 | 15.0 | 0.48 |
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