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How low do we go? Is duration of a ‘high’ integral to the definition of bipolar disorder?

Published online by Cambridge University Press:  24 June 2014

Lucy Tully  and
Gordon Parker
Lucy Tully
Affiliation:
School of Psychiatry, University of New South Wales, Sydney, Australia Black Dog Institute, Sydney, Australia
Gordon Parker*
Affiliation:
School of Psychiatry, University of New South Wales, Sydney, Australia Black Dog Institute, Sydney, Australia
*
Professor Gordon Parker, Black Dog Institute, Hospital Road, Randwick, Sydney 2031, Australia. Tel: 61 02 9382 4372; Fax: 02 9382 8208; E-mail: g.parker@unsw.edu.au
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Abstract

Objective:

There has been considerable debate about the diagnostic rules for bipolar II disorder, particularly the 4-day duration criteria for hypomanic episodes. This study examined whether highs lasting minutes or hours differed from longer highs in terms of clinical features and symptom severity. It also examined whether duration of highs predicted bipolar disorder being diagnosed.

Method:

A total of 518 subjects with significant episodes of depression and ‘highs’ completed a web-based self-report questionnaire. Those who reported their longest highs lasting minutes or hours were compared with those who reported longer durations of highs on a range of clinical variables and measures of symptom severity.

Results:

Subjects whose highs lasted minutes or hours reported clinical features and severity of symptoms similar to those whose highs lasted 3–7 days. However, the odds of being diagnosed with bipolar disorder for those with highs lasting 3–7 days were almost three times higher than for those whose highs lasted minutes or hours.

Conclusion:

The 4-day DSM-IV minimum-duration criteria for hypomania may lead to failure to diagnose subjects with brief highs who have true bipolar disorder and thus should be reconsidered.

Keywords

bipolar disorderDSM-IVduration criteriahighshypomania
Type
Research Article
Information
Acta Neuropsychiatrica , Volume 19 , Issue 1 , February 2007 , pp. 38 - 44
Copyright
Copyright © 2007 Blackwell Munksgaard

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