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Multicenter Study
. 2011 Mar;123(3):206-10.
doi: 10.1111/j.1600-0447.2010.01602.x. Epub 2010 Sep 5.

Depressive and manic symptoms are not opposite poles in bipolar disorder

S L Johnson  1 , R Morriss, J Scott, E Paykel, P Kinderman, R Kolamunnage-Dona, R P Bentall
Affiliations
Multicenter Study

Depressive and manic symptoms are not opposite poles in bipolar disorder

S L Johnson et al. Acta Psychiatr Scand. 2011 Mar.

Abstract

Objective: This study of 236 individuals with bipolar disorders employed longitudinal analyses to determine whether the symptoms of mania and depression can be understood as one dimension (with depression and mania as opposites) or two relatively independent dimensions.

Method: Weekly severity ratings of manic and depression were assessed using the Longitudinal Interval Follow-up Evaluation-II for 72 weeks. The within-subjects correlation of manic and depressive severity was examined using random effects regression.

Results: Contrary to the one-dimension model, mania and depression symptoms were not negatively related. Indeed, the correlations of mania with depressive symptoms were quite small.

Conclusion: The data suggest that depressive and manic symptoms are not opposite poles. Rather depressive and manic symptoms appear to fluctuate relatively independently within bipolar disorder.

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Conflict of interest statement

Declaration of interest

Sheri Johnson has received funding from the National Cancer Institute and the National Institute of Mental Health. Richard Morris has received speaker’s fees from Lilly and Astra Zeneca and has received grant funding from the UK National Institute for Health Research. Jan Scott has received speaker fees from Jansen-Cilag, AstraZeneca and Eli Lilly and grants from the Medical Research Council and the Research for Patient Benefit Programme. Eugene Paykel has received a speaker fee from Eli Lilly. Ruwanthi Kolamunnage-Dona is funded by Medical Research Council Grant G0400615. Richard Bentall has received grant support from the Medical Research Council, the National Institute of Health Research programme and the Welsh Office of Research and Development. The authors of this paper certify that the publication of findings of this study would not influence their fees, consultancy employment or compensation from any agency.

Figures

Fig. 1
Fig. 1
Predicted mania scores as a function of current depression levels.
Fig. 2
Fig. 2
Predicted depression scores as a function of current, 1-week lag, and 2-week lag mania levels.
Fig. 3
Fig. 3
Mania and depression as separable dimensions.
See this image and copyright information in PMC

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