TABLE 2.
Reported prevalence and duration of prodromal symptoms prior to First Episode Mania (FEM) or Prior to First Episode Psychosis (FEP)
| Prodromal symptom characteristics | Prevalence (Yes/No) | Duration (Months) | ||||||||
|---|---|---|---|---|---|---|---|---|---|---|
| FEM (n = 72, 66.7%) | FEP (n = 36, 33.3%) | X 2 or F, p value | FEM (n = 72, 66.7%) | FEP (n = 36, 33.3%) | t, p value | |||||
| N | % | N | % | Mean | SD | Mean | SD | |||
| Mania Index Symptoms | ||||||||||
| Increased energy or goal‐directed activity | 38 | 52.8 | 3 | 8.3 | 18.827, <0.001 | 2.42 | 2.11 | 3.33 | 0.58 | −0.737, 0.465 |
| Overly cheerful, happy, on top of the world | 27 | 37.5 | 4 | 11.1 | 6.928, 0.008 | 2.13 | 1.46 | 3.50 | 1.91 | −1.685, 0.103 |
| Racing thoughts | 24 | 33.3 | 5 | 13.9 | 3.683, 0.055 | 2.39 | 2.38 | 3.20 | 1.92 | −0.705, 0.487 |
| Overly talkative | 27 | 37.5 | 1 | 2.8 | 13.313, <0.001 | 2.09 | 1.26 | 2.00 | ‐ | 0.072, 0.943 |
| Decreased need for sleep | 25 | 34.7 | 2 | 5.6 | 9.389, 0.002 | 2.88 | 6.95 | 1.50 | 0.71 | 0.276, 0.785 |
| Irritability or anger | 29 | 40.3 | 11 | 30.6 | 0.601, 0.438 | 2.93 | 2.67 | 11.36 | 10.54 | −2.622, 0.025 |
| Overly self‐confidence | 22 | 30.6 | 2 | 5.6 | 7.292, 0.007 | 2.20 | 1.31 | 2.50 | 0.70 | −0.309, 0.760 |
| Increased sexual interest | 12 | 16.7 | 2 | 5.6 | 2.626, 0.135 | 2.20 | 1.23 | 4.00 | 1.41 | −1.878, 0.085 |
| Reckless or dangerous behaviours | 4 | 5.6 | 2 | 5.6 | 0.000, 1.000 | 1.25 | 0.50 | 2.00 | 0.00 | −2.000, 0.116 |
| Risky sexual behaviour | 4 | 5.6 | 1 | 2.8 | 0.419, 0.663 | 1.50 | 1.00 | 2.00 | ‐ | −0.447, 0.685 |
| Mania or Depression Index Symptoms | ||||||||||
| Lack of concentration | 21 | 29.2 | 10 | 27.8 | 0.000, 1.000 | 2.81 | 2.05 | 9.70 | 8.18 | −2.625, 0.026 |
| Physical agitation | 26 | 36.1 | 4 | 11.1 | 6.283, 0.012 | 1.96 | 1.39 | 6.50 | 7.68 | −1.179, 0.323 |
| Depression Index Symptoms | ||||||||||
| Depressed mood | 1 | 1.4 | 5 | 13.9 | 7.147, 0.015 | 4.00 | ‐ | 12.80 | 8.41 | −0.955, 0.393 |
| Tiredness or lack of energy | 2 | 2.8 | 7 | 19.4 | 8.573, 0.006 | 9.00 | 7.07 | 13.57 | 12.49 | −0.480, 0.646 |
| Anhedonia | 6 | 8.3 | 6 | 16.7 | 1.688, 0.209 | 6.00 | 3.74 | 10.17 | 8.95 | −1.052, 0.329 |
| Insomnia | 28 | 38.9 | 14 | 38.9 | 0.000, 1.000 | 3.28 | 6.57 | 9.54 | 7.73 | −2.680, 0.011 |
| Feeling of worthlessness or guilt | 2 | 2.8 | 2 | 5.6 | 0.519, 0.599 | 3.50 | 0.71 | 9.50 | 12.02 | −0.705, 0.554 |
| Weight loss or decrease in appetite | 9 | 12.5 | 6 | 16.7 | 0.087, 0.768 | 4.05 | 3.50 | 9.17 | 7.91 | −1.725, 0.108 |
| Physically slowed down | 3 | 4.2 | 6 | 16.7 | 4.909, 0.057 | 6.33 | 6.80 | 19.00 | 11.30 | −1.753. 0.123 |
| Thinking about suicide | 2 | 2.8 | 2 | 5.6 | 0.519, 0.599 | 13.50 | 14.85 | 9.50 | 12.02 | 0.296, 0.795 |
| Hypersomnia | 0 | ‐ | 2 | 5.6 | 4.075, 0.109 | ‐ | ‐ | 10.50 | 9.19 | ‐ |
| Attempting suicide | 0 | ‐ | 1 | 2.8 | 2.019, 0.333 | ‐ | ‐ | 14.00 | ‐ | ‐ |
| Weight gain or increasing in appetite | 3 | 4.2 | 2 | 5.6 | 0.105, 1.000 | 3.67 | 2.31 | 9.50 | 2.12 | −2.842, 0.066 |
| General Index Symptoms | ||||||||||
| Educational and occupational dysfunction | 17 | 23.6 | 13 | 36.1 | 1.298, 0.255 | 5.22 | 6.18 | 11.54 | 11.16 | −1.827, 0.085 |
| Anxiety or nervousness | 28 | 38.9 | 18 | 50.0 | 0.800, 0.371 | 3.96 | 3.91 | 7.71 | 8.19 | −1.758, 0.093 |
| Social Isolation | 7 | 9.7 | 12 | 33.3 | 7.672, 0.006 | 2.93 | 1.88 | 11.33 | 10.07 | −2.809, 0.015 |
| Mood lability | 33 | 45.8 | 7 | 19.4 | 6.080, 0.014 | 3.26 | 6.10 | 8.14 | 9.06 | −1.362, 0.214 |
| Ambivalence/difficulty making decisions | 3 | 4.2 | 8 | 22.2 | 8.553, 0.006 | 3.17 | 1.44 | 5.50 | 4.28 | −0.899, 0.392 |
| Obsessions and compulsions | 10 | 13.9 | 6 | 16.7 | 0.009, 0.924 | 3.35 | 1.83 | 5.17 | 2.86 | −1.564, 0.140 |
| Losing temper frequently or trouble controlling anger | 11 | 78.6 | 3 | 8.3 | 1.077, 0.375 | 1.64 | 1.21 | 9.33 | 12.74 | −1.045, 0.405 |
| Day/Night Sleep Reversal | 2 | 2.8 | 0 | ‐ | 1.019, 0.551 | 14.00 | 16.97 | ‐ | ‐ | ‐ |
| Self‐harming behaviour (no intent to kill self) | 0 | ‐ | 0 | ‐ | ‐ | ‐ | ‐ | ‐ | ‐ | ‐ |
| Oppositionality | 2 | 2.8 | 1 | 2.8 | 0.000, 1.000 | 2.50 | 0.71 | 2.00 | ‐ | 0.577, 0.667 |
| Increased creativity | 23 | 31.9 | 1 | 2.8 | 10.185, 0.001 | 2.65 | 2.66 | 3.00 | ‐ | −0.128, 0.899 |
| Giddy, clownish | 2 | 2.8 | 1 | 2.8 | 0.000, 1.000 | 1.50 | 0.71 | 3.00 | ‐ | −1.732, 0.333 |
| Psychosis, Mania and Depression Index Symptoms | ||||||||||
| Difficulty thinking or communicating clearly | 4 | 5.6 | 6 | 16.7 | 3.527, 0.081 | 2.37 | 1.38 | 15.83 | 13.06 | −2.503, 0.053 |
| Psychosis Index Symptoms | ||||||||||
| Suspiciousness/persecutory ideas | 11 | 15.3 | 13 | 36.1 | 4.882, 0.027 | 2.91 | 3.33 | 5.15 | 3.21 | −1.678, 0.108 |
| Strange or unusual ideas | 17 | 23.6 | 12 | 33.3 | 0.713, 0.398 | 2.82 | 3.02 | 4.12 | 2.31 | 0.026, 0.222 |
| Hallucinations | 1 | 1.4 | 1 | 2.8 | 0.255, 1.000 | 2.00 | ‐ | 3.00 | ‐ | ‐ |
| FEM (n = 92) | FEP (n = 28) | t, p value | FEM (n = 92) | FEP (n = 28) | t, p value | |||||
|---|---|---|---|---|---|---|---|---|---|---|
| Mean | SD | Mean | SD | Mean | SD | Mean | SD | |||
| Mania Index | 3.65 | 2.74 | 1.47 | 2.18 | 4.482, <0.001 | 2.84 | 3.84 | 11.48 | 10.94 | 3.377, 0.003 |
| Depression Index | 1.46 | 1.52 | 2.03 | 1.92 | −1.533, 0.131 | 3.63 | 5.58 | 10.52 | 8.93 | 3.489, 0.001 |
| General Psychopathology Index | 1.90 | 1.56 | 1.94 | 1.76 | −0.129, 0.897 | 3.56 | 3.61 | 9.18 | 7.78 | 3.379, 0.002 |
| Psychosis Index | 0.46 | 0.75 | 0.89 | 1.06 | −2.175, 0.034 | 2.63 | 2.70 | 7.97 | 8.51 | 2.500, 0.022 |
| BPSS‐R Total Score | 6.70 | 4.62 | 5.61 | 4.73 | 1.146, 0.254 | 3.15 | 3.22 | 8.8 | 7.42 | 3.884, <0.001 |
Abbreviations: BPSS‐R, Bipolar Prodrome Symptom Scale‐Retrospective. Bold for statistically significant p values; FEM, First Episode Mania; FEP, First Episode Psychosis; SD, Standard Deviation.