Evidence map›Paper›PMID 34821429›Full record

ArticleBipolar disorders2022

Clinical profiles of subsequent stages in bipolar disorder: Results from the Dutch Bipolar Cohort.

Afra van der Markt, Ursula M H Klumpers, Annemiek Dols, Marco P Boks, Annabel Vreeker, Aartjan T F Beekman, Ralph W Kupka

Abstract read
In one paragraph

Article in Bipolar disorders, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Clinical staging and profiling of affective disorders.Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology · 2026
    Review
  2. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Afra van der MarktAmsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Psychiatry, The Netherlands.ORCID 0000-0002-4022-9438
Ursula M H KlumpersGGZ inGeest Specialized Mental Health Care, Amsterdam, The Netherlands.ORCID 0000-0002-8273-2496
Annemiek DolsAmsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Psychiatry, The Netherlands.ORCID 0000-0003-1964-0318
Marco P BoksDepartment of Psychiatry, University Medical Center Utrecht, Utrecht, The Netherlands.ORCID 0000-0001-6163-7484
Annabel VreekerDepartment of Child and Adolescent Psychiatry and Psychology, Erasmus MC, Rotterdam, The Netherlands.
Aartjan T F BeekmanAmsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Psychiatry, The Netherlands.ORCID 0000-0003-2382-1410
Ralph W KupkaAmsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Psychiatry, The Netherlands.ORCID 0000-0002-1662-7436

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionThe manifestation of bipolar disorder (BD) is hypothesized to be determined by clinical characteristics such as familial loading, childhood abuse, age at onset, illness duration, comorbid psychiatric disorders, addiction, treatment resistance, and premorbid cognitive functioning. Which of these are associated with a more severe course and worse outcome is currently unknown. Our objective is to find a combination of clinical characteristics associated with advancement to subsequent stages in two clinical staging models for BD.

methodsUsing cross-sectional data from the Dutch Bipolar Cohort, staging was applied to determine the progression of bipolar-I-disorder (BD-I; N = 1396). Model A is primarily defined by recurrence of mood episodes, ranging from prodromal to chronicity. Model B is defined by level of inter-episodic functioning, ranging from prodromal to inability to function autonomously. For both models, ordinal logistic regression was conducted to test which clinical characteristics are associated with subsequent stages.

resultsFor model A, familial loading, childhood abuse, earlier onset, longer illness duration, psychiatric comorbidity, and treatment resistance were all predictors for a higher stage in contrast to addiction and cognitive functioning. For model B, childhood abuse, psychiatric comorbidity, cognitive functioning, and treatment resistance were predictors for a more severe stage, whereas age at onset, illness duration, and addiction were not. DISCUSSION/

conclusionsDifferences in clinical characteristics across stages support the construct validity of both staging models. Characteristics associated with a higher stage largely overlapped across both models. This study is a first step toward determining different clinical profiles, with a corresponding course and outcome.

Indexed as

Bipolar DisorderAffectChildCohort StudiesComorbidityCross-Sectional StudiesHumansbipolar disordersmood episodes, profilesstagingstaging models

Identifiers

PMID34821429
PMCPMC9542330

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