Bipolar II Disorder: Personality and Outcome in two Clinical Samples

• Published in: Australian and New Zealand journal of psychiatry 2004-06, Vol.38 (6), p.433-438
• Main Authors: Joyce, Peter R., Luty, Suzanne E., McKenzie, Janice M., Mulder, Roger T., McIntosh, Virginia V., Carter, Frances A., Bulik, Cynthia M., Sullivan, Patrick F.
• Format: Article
• Language: English
• Subjects: Adrenergic Uptake Inhibitors - therapeutic use; Adult; Behavior therapy. Cognitive therapy; Biological and medical sciences; Bipolar Disorder - diagnosis; Bipolar Disorder - drug therapy; Bipolar Disorder - epidemiology; Bulimia - epidemiology; Bulimia - therapy; Cognitive Therapy - methods; Depressive Disorder, Major - diagnosis; Depressive Disorder, Major - drug therapy; Depressive Disorder, Major - epidemiology; Diagnostic and Statistical Manual of Mental Disorders; Drugs; Female; Fluoxetine - therapeutic use; Follow-Up Studies; Humans; Male; Medical sciences; Medicin och hälsovetenskap; Medicine; Mental health; Neuropharmacology; Nortriptyline - therapeutic use; Personality; Personality Disorders - diagnosis; Personality Disorders - epidemiology; Pharmacology. Drug treatments; Psychoanaleptics: cns stimulant, antidepressant agent, nootropic agent, mood stabilizer..., (alzheimer disease); Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Psychopharmacology; Serotonin Uptake Inhibitors - therapeutic use; Therapeutics; Treatments
• ISSN: 0004-8674; 1440-1614
• DOI: 10.1080/j.1440-1614.2004.01380.x

Objective: To compare the personality traits and disorders of patients with bipolar II disorder and major depression and to examine the impact on treatment outcome of a bipolar II diagnosis. Method: Patients from two clinical trials, a depressive sample (n = 195, 10% bipolar II) and a bulimic sample (n = 135, 16% bipolar II), were assessed for personality traits using DSM-IV criteria. Patients were randomised to treatments (fluoxetine or nortriptyline for depressive sample; cognitive behaviour therapy for bulimic sample) and followed for 3 years (depressive sample) or 5 years (bulimic sample) to assess the impact on outcome of a bipolar II diagnosis. Results: Bipolar II patients were assessed as having more borderline, histrionic and schizotypal personality traits than patients with major depression. A baseline bipolar II diagnosis did not impact negatively on treatment outcome, and less than 5% of bipolar II patients developed bipolar I disorder during follow up. Conclusions: The low rate of conversion of bipolar II to bipolar I disorder and the lack of adverse impact of the diagnosis on outcome, questions the need for antimanic or mood stabliser medication in most bipolar II patients.