PRODROMAL AND RESIDUAL SYMPTOMS IN BIPOLAR-I DISORDER

The objective of the current study was to better understand the nature of prodromal and residual symptoms of mania and depression, as report ed by patients with bipolar I disorder and their family members. Prodr omal and residual symptoms of mania and depression were elicited from 74 patients with bipolar I disorder. In 45 cases, an adult family memb er provided similar information. Three clinicians classified the sympt oms into six broad categories: behavioral, cognitive, mood, neuroveget ative, social, and other. The clinicians also categorized symptoms as typical or idiosyncratic. Seventy-eight percent of the patients report ed prodromal depressive symptoms and 87% reported prodromal manic symp toms; greater than half of the patients disclosed residual symptoms of depression (54%) and mania (68%). Within each of these four illness c ategories, cognitive symptoms were consistently the most common sympto ms reported by patients. A substantial number of symptoms were idiosyn cratic, particularly those reported for residual depression. Agreement between patient and family members on reported symptoms was strong fo r the prodromal phase of both polarities, but less so for the residual phases. These preliminary results suggest that patients with bipolar I disorder and their family members can identify prodromal and residua l symp toms, that these symptoms are quite common, and that prodromal symptoms may be more prevalent or easier to identify than residual sym ptoms. Cognitive symptoms were consistently the most common symptoms r eported by patients. Copyright (C) 1996 by W.B. Saunders Company.