A systematic review of manic and depressive prodromes

Jackson, A., Cavanagh, J. and Scott, J. (2003) A systematic review of manic and depressive prodromes. Journal of Affective Disorders, 74(3), pp. 209-217. (doi: 10.1016/S0165-0327(02)00266-5)

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Background: This paper explores whether individuals with a mood disorder can identify the nature and duration of depressive and manic prodromes. Methods: Seventy-three publications of prodromal symptoms in bipolar and unipolar disorders were identified by computer searches of seven databases (including medline and Psyclit) supplemented by hand searches of journals. Seventeen studies (total sample=1191 subjects) met criteria for inclusion in a systematic review. Results: At least 80% of individuals with a mood disorder can identify one or more prodromal symptoms. There are limited data about unipolar disorders. In bipolar disorders, early symptoms of mania are identified more frequently than early symptoms of depression. The most robust early symptom of mania is sleep disturbance (median prevalence 77%). Early symptoms of depression are inconsistent. The mean length of manic prodromes (>20 days) was consistently reported to be longer than depressive prodromes (<19 days). However, depressive prodromes showed greater inter-individual variation (ranging from 2 to 365 days) in duration than manic prodromes (1–120 days). Limitations: Few prospective studies of bipolar, and particularly unipolar disorders have been reported. Conclusions: Early symptoms of relapse in affective disorders can be identified. Explanations of the apparent differences in the recognition and length of prodromes between mania and bipolar depression are explored. Further research on duration, sequence of symptom appearance and characteristics of prodromes is warranted to clarify the clinical usefulness of early symptom monitoring.

Item Type:Articles
Glasgow Author(s) Enlighten ID:Cavanagh, Professor Jonathan and Jackson, Dr Alison and Scott, Dr Jane
Authors: Jackson, A., Cavanagh, J., and Scott, J.
College/School:College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Mental Health and Wellbeing
College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing > Clinical Specialities
Journal Name:Journal of Affective Disorders
Publisher:Elsevier BV

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