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Several biological and environmental factors and comorbidities have been implicated in the significant variability in the long-term course of bipolar illness. From a Stanley Foundation clinical trial database, the researchers used up to 7 years of nontrial data, obtained monthly, on 711 patients with bipolar disorder (57% female) to examine factors that might account for variability in the time that patients spend in depressed, hypomanic, manic, and euthymic states.
Examined factors included bipolar I or II diagnosis (type I, 80% of the sample), rapid cycling (15%), comorbid anxiety disorders (29%), comorbid substance use disorders (34%), and age (mean, 42.3 years at entry). Overall, patients showed depressive, hypomanic, or manic symptoms a…