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The British Journal of Psychiatry
Year: 2009  |  Volume: 195  |  Issue: 6  |  Page No.: 525 - 530

Empirical typology of bipolar I mood episodes

D. A Solomon, A. C Leon, J Endicott, W. H Coryell, C Li, J. G Fiedorowicz and M. B. Keller    



Much remains unknown about the phenomenology of bipolar I disorder.


To determine the type of bipolar I mood episodes that occur over time, and their relative frequency.


A total of 219 individuals with Research Diagnostic Criteria bipolar I disorder were prospectively followed for up to 25 years (median 20 years). Psychopathology was assessed with the Longitudinal Interval Follow-up Evaluation.


Overall, 1208 mood episodes were prospectively observed. The episodes were empirically classified as follows: major depression, 30.9% (n = 373); minor depression, 13.0% (n = 157); mania, 20.4% (n = 246); hypomania, 10.4% (n = 126); cycling, 17.3% (n = 210); cycling plus mixed state, 7.8% (n = 94); and mixed, 0.2% (n = 2).


Cycling episodes constituted 25% of all episodes. Work groups revising ICD–10 and DSM–IV should add a category for bipolar I cycling episode.

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