Affective instability and the course of bipolar depression: results from the STEP-BD randomised controlled trial of psychosocial treatment

The British Journal of Psychiatry : the Journal of Mental Science
Jonathan P StangeThilo Deckersbach

Abstract

Little is known about predictors of recovery from bipolar depression. We investigated affective instability (a pattern of frequent and large mood shifts over time) as a predictor of recovery from episodes of bipolar depression and as a moderator of response to psychosocial treatment for acute depression. A total of 252 out-patients with DSM-IV bipolar I or II disorder and who were depressed enrolled in the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD) and were randomised to one of three types of intensive psychotherapy for depression (n= 141) or a brief psychoeducational intervention (n= 111). All analyses were by intention-to-treat. Degree of instability of symptoms of depression and mania predicted a lower likelihood of recovery and longer time until recovery, independent of the concurrent effects of symptom severity. Affective instability did not moderate the effects of psychosocial treatment on recovery from depression. Affective instability may be a clinically relevant characteristic that influences the course of bipolar depression.

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Citations

Oct 30, 2016·Expert Review of Molecular Diagnostics·Antonio L TeixeiraRodrigo Machado-Vieira
Jan 25, 2019·European Psychiatry : the Journal of the Association of European Psychiatrists·A G SzmulewiczS A Strejilevich
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Oct 16, 2019·Journal of Affective Disorders·Jonathan P StangeTimothy J Trull

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Bipolar disorder is characterized by manic and/or depressive episodes and associated with uncommon shifts in mood, activity levels, and energy. Discover the latest research this illness here.