Bipolar disorder is characterized by cyclical changes in mood, energy and activity levels that range from deep depression, to mania or hypomania.
The research involved 2600 patients from the STEP-BP (Systematic Treatment Enhancement Program for Bipolar Disorder) study. Participants completed a questionnaire on family history, with 75.5 percent of the subjects reporting they had a first-degree family member with a history of mania or depression.
The findings from the study show that patients with a family history of mood disorders were younger than those without at symptom onset, at 21 versus 23 years for mania, and 17 versus 20 years for depression. The family history patients also had experienced significantly more manic or depressed phases and were more likely to have attempted suicide, at 40 percent versus 33 percent.
Also, more patients with than without a positive family history met the criteria for rapid cycling, at 51 percent versus 40 percent. And those with a family history were more likely than those without to have comorbid anxiety disorders.
“Indeed, a shared genetic etiology has been suggested between mood and anxiety disorders,” said researchers Niki Antypa, Ph.D., and Alessandro Serretti, M.D., Ph.D., from the University of Bologna in Italy.
Not only did patients with a family history have more severe symptoms at presentation, but they also had greater severity of certain symptoms during one year of follow-up.
All depressive symptoms tended to be more severe, with this reaching significance for reduced energy and concentration, and for suicidality. Most manic symptoms were also more severe, particularly for racing thoughts and distraction.
“All of these ‘mental activation’ symptoms reflect cognitive functions that are often impaired in [bipolar disorder],” said the researchers, in the Journal of Affective Disorders.
Having more severe symptoms negatively affected patients’ quality of life; those with a positive family history had significantly lower scores than those without on the Quality of Life Enjoyment and Satisfaction Short Form, both at baseline and during follow-up.
“If these observations are robust, systematic monitoring of cognitive symptomatology and tailored treatment, perhaps through cognitive remediation techniques, could improve functional outcome in bipolar patients with [a family history] of mood disorders,” wrote the researchers.
Source: Journal of Affective Disorders