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“Folie circulaire” vs “Folie à double forme”: Contribution from a French national study

Published online by Cambridge University Press:  16 April 2020

J.-M. Azorin ,
A. Kaladjian ,
N. Besnier ,
M. Adida ,
E.-G. Hantouche ,
S. Lancrenon  and
H. Akiskal
J.-M. Azorin*
Affiliation:
SHU psychiatrie adultes, Sainte-Marguerite Hospital, University of Marseille, 13274Marseille cedex 9, France
A. Kaladjian
Affiliation:
SHU psychiatrie adultes, Sainte-Marguerite Hospital, University of Marseille, 13274Marseille cedex 9, France
N. Besnier
Affiliation:
SHU psychiatrie adultes, Sainte-Marguerite Hospital, University of Marseille, 13274Marseille cedex 9, France
M. Adida
Affiliation:
SHU psychiatrie adultes, Sainte-Marguerite Hospital, University of Marseille, 13274Marseille cedex 9, France
E.-G. Hantouche
Affiliation:
Pitié-Salpêtrière Hospital, University of Paris VI, Paris, France
S. Lancrenon
Affiliation:
Sylia-Stat, Bourg-La-Reine, France
H. Akiskal
Affiliation:
International Mood Center, La Jolla, CA, USA
*
*Corresponding author. Tel.: +33 4 91 74 40 82; fax: +33 4 91 74 55 78. E-mail address: jazorin@ap-hm.fr (J.-M. Azorin).
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Abstract

Objective

To check whether the presence or not of free intervals between episodes could help differentiate subtypes of bipolar disorder, as suggested by the seminal controversy between Falret and Baillarger.

Methods

From 1090 bipolar I patients included in a French national study, 981 could be classified as with or without free intervals and assessed for demographic and illness characteristics.

Results

Compared with patients with free intervals (n = 722), those without (n = 259) had an earlier age at onset, more episodes, suicide attempts, cyclothymic and irritable temperaments. The following independent variables were associated with no free intervals: being single or divorced, delay to mood stabilizer treatment, multiple hospitalizations, incongruent psychotic features, panic and generalized anxiety disorder.

Conclusions

“Folie à double forme” (without free intervals) and “folie circulaire” (with free intervals) may actually refer to early and later onset bipolar subtypes, insofar as most differences we found between them were previously evidenced between the latter two. We cannot, however, exclude that they might simply be two separate subtypes, whose main characteristics could be accounted for by different explanatory factors.

Keywords

Bipolar disorderFree intervalsInterepisode recoveryAge at onset“Folie circulaire”“Folie à double forme”
Type
Original article
Information
European Psychiatry , Volume 26 , Issue 6 , September 2011 , pp. 375 - 380
Copyright
Copyright © Elsevier Masson SAS 2011

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