The significance of past mania or hypomania in the course and outcome of major depression

Am J Psychiatry. 1987 Mar;144(3):309-15. doi: 10.1176/ajp.144.3.309.


Patients with primary major depression (N = 372) were followed for 2 years to determine the prognostic importance of past manic or hypomanic episodes. While bipolar I and bipolar II patients were more likely to relapse and bipolar I patients were more likely to attempt suicide, these patients resembled nonbipolar depressed patients in likelihood of recovery and psychosocial impairment in various areas. Compared to nonbipolar patients, those with bipolar I depression were much more likely to develop mania, while bipolar II patients were more likely to develop hypomania. Cycling during the index episode predicted a relatively low likelihood of recovery for bipolar I patients but had no apparent prognostic significance for patients with bipolar II illness.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Bipolar Disorder / complications
  • Bipolar Disorder / diagnosis*
  • Bipolar Disorder / psychology
  • Depressive Disorder / complications
  • Depressive Disorder / diagnosis*
  • Depressive Disorder / psychology
  • Diagnosis, Differential
  • Female
  • Follow-Up Studies
  • Hospitalization
  • Humans
  • Male
  • Outcome and Process Assessment, Health Care
  • Time Factors