Influence of sub-syndromal symptoms after remission from manic or mixed episodes

Mauricio Tohen, Charles L. Bowden, Joseph R. Calabrese, Daniel Lin, Tammy D. Forrester, Gary S. Sachs, Athanasios Koukopoulos, Lakshmi Yatham, Heinz Grunze

Research output: Contribution to journalArticle

65 Citations (Scopus)

Abstract

Background: Sub-syndromal symptoms in bipolar disorder impair functioning and diminish quality of life. Aims: To examine factors associated with time spent with sub-syndromal symptoms and to characterise how these symptoms influence outcomes. Method: In a double-blind randomised maintenance trial, patients received either olanzapine or lithium monotherapy for 1 year. Stepwise logistic regression models were used to identify factors that were significant predictors of percentage time spent with sub-syndromal symptoms. The presence of sub-syndromal symptoms during the first 8 weeks was examined as a predictor of subsequent relapse. Results: Presence of sub-syndromal depressive symptoms during the first 8 weeks significantly increased the likelihood of depressive relapse (relative risk 4.67, P < 0.001). Patients with psychotic features and those with a greater number of previous depressive episodes were more likely to experience sub-syndromal depressive symptoms (RR=2.51, P < 0.001 and RR=2.35, P=0.03 respectively). Conclusions: These findings help to identify patients at increased risk of affective relapse and suggest that appropriate therapeutic interventions should be considered even when syndromal-level symptoms are absent.

Original languageEnglish (US)
Pages (from-to)515-519
Number of pages5
JournalBritish Journal of Psychiatry
Volume189
Issue numberDEC.
DOIs
StatePublished - Dec 2006

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olanzapine
Recurrence
Logistic Models
Depression
Bipolar Disorder
Lithium
Maintenance
Quality of Life
Therapeutics

ASJC Scopus subject areas

  • Neuroscience(all)
  • Psychiatry and Mental health

Cite this

Tohen, M., Bowden, C. L., Calabrese, J. R., Lin, D., Forrester, T. D., Sachs, G. S., ... Grunze, H. (2006). Influence of sub-syndromal symptoms after remission from manic or mixed episodes. British Journal of Psychiatry, 189(DEC.), 515-519. https://doi.org/10.1192/bjp.bp.105.020321

Influence of sub-syndromal symptoms after remission from manic or mixed episodes. / Tohen, Mauricio; Bowden, Charles L.; Calabrese, Joseph R.; Lin, Daniel; Forrester, Tammy D.; Sachs, Gary S.; Koukopoulos, Athanasios; Yatham, Lakshmi; Grunze, Heinz.

In: British Journal of Psychiatry, Vol. 189, No. DEC., 12.2006, p. 515-519.

Research output: Contribution to journalArticle

Tohen, M, Bowden, CL, Calabrese, JR, Lin, D, Forrester, TD, Sachs, GS, Koukopoulos, A, Yatham, L & Grunze, H 2006, 'Influence of sub-syndromal symptoms after remission from manic or mixed episodes', British Journal of Psychiatry, vol. 189, no. DEC., pp. 515-519. https://doi.org/10.1192/bjp.bp.105.020321
Tohen M, Bowden CL, Calabrese JR, Lin D, Forrester TD, Sachs GS et al. Influence of sub-syndromal symptoms after remission from manic or mixed episodes. British Journal of Psychiatry. 2006 Dec;189(DEC.):515-519. https://doi.org/10.1192/bjp.bp.105.020321
Tohen, Mauricio ; Bowden, Charles L. ; Calabrese, Joseph R. ; Lin, Daniel ; Forrester, Tammy D. ; Sachs, Gary S. ; Koukopoulos, Athanasios ; Yatham, Lakshmi ; Grunze, Heinz. / Influence of sub-syndromal symptoms after remission from manic or mixed episodes. In: British Journal of Psychiatry. 2006 ; Vol. 189, No. DEC. pp. 515-519.
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