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January 2011



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By Rick Nauert PhD Senior News Editor
Reviewed by John M. Grohol, Psy.D. on April 14, 2010    

A genetic test for bipolar disorder is on the horizon say researchers from Indiana University School of Medicine.
The scientists published a “prototype” for laboratory testing in the online edition of the American Journal of Medical Genetics Part B: Neuropsychiatric Genetics.  “This is an important advance in the development of a prototype for lab tests for bipolar disorder, and can serve as a model for developing tests in other complex disorders,” said lead author Alexander B. Niculescu III, M.D., Ph.D.
Dr. Niculescu and colleagues used two different populations from large scale genetic studies and compared those individuals’ genes to a small panel of 56 genes implicated in bipolar disorder by their work, to predict who has a predisposition to the disease.    

The analysis resulted in a genetic risk prediction score that indicates high or low potential for developing bipolar disorder.
“The coupling of a high score with certain environmental factors may be a predictor, not a certainty, that the individual will develop bipolar disorder” said Dr. Niculescu, who also is a staff psychiatrist at the Indianapolis Roudebush VA Medical Center.    


“Genes explain a small portion of the risk of developing the illness,” said Dr. Niculescu.
“Unlike some genetic predisposition to diseases like Huntington’s or cystic fibrosis, the variances in genes that can predispose people to mood disorders are found in all of us. What we are learning is that it may take a combination of factors – too many gene variances in the wrong environment and you are at higher risk.”    

The predictive value of the genetic risk factors could be useful in screening before the disorder manifests itself clinically, and the implementation of interventions to lower stress, adjust regular sleep hours and other life style factors that could serve as an environmental deterrent for developing bipolar disorder.


Closer follow-up and earlier therapeutic intervention may be useful for individuals who are at higher risk.

Authors on the study include Sagar D. Patel, Dr. Helen Le-Niculescu, Dr. Daniel Koller, Stephen D. Green, Dr. Debomoy K. Lahiri, Dr. Francis J. McMahon and Dr. John I. Nurnberger, Jr.    

The research was funded by the Veterans Administration as well as the National Institute of Mental Health.

In a corresponding editorial in the American Journal of Medical Genetics, Dr. Alexander B. Niculescu and Dr. Helen Le-Niculescu advocate for a more efficient way to identify genes involved with mental disorders.    



How Long is a Typical Bipolar Episode?

By John M Grohol PsyD

How Long is a Typical Bipolar Episode?


Bipolar disorder is characterized by a cycling from depression to mania, and back again over time (hence the reason it used to be called manic depression, because it includes both mania and depression). One of the commonly asked questions we get here is, “How long does a typical bipolar episode last?”

The answer has traditionally been, “Well, it varies considerably from person to person. Some may have rapid cycling bipolar disorder where that person can cycle back and forth between depression and mania in the course of a day or multiple times a week. Others may be stuck in one mood or the other for weeks or months at a time.”   

New research (Solomon et al., 2010) published in The Archives of General Psychiatry sheds a little more empirical light onto this question.


In a study of 219 patients with bipolar I disorder (the more serious kind of bipolar disorder), researchers asked patients to fill out an evaluation every 6 months for five years. The evaluation survey asked a number of questions to determine the length, type and severity of the person’s mood episodes.  They discovered that for patients with Bipolar I disorder, the median duration for any type of mood episode — either mania or depression — was 13 weeks.

They also found that “more than 75% of the subjects recovered from their mood episodes within 1 year of onset. The probability of recovery was significantly less for an episode with severe onset” and for those who had a greater number of years spent ill with a mood episode.   

The researchers also discovered that manic episodes or mild depressive episodes were easier to recover from than severe depressive episodes for people with Bipolar I disorder in this study. They also found that those who have a cycling episode — switching from depression to mania or vice-a-versa without an intervening period of recovery — fared worse.
So there you have it. The average length of time someone with Bipolar I disorder spends either depressed or manic is about 13 weeks. Of course, as always, your mileage may vary and individual differences will mean that very few people will actually have this exact average. But it’s a good, rough yardstick in which to measure your own mood episode lengths.   

Solomon, DA, Andrew C. Leon; William H. Coryell; Jean Endicott; Chunshan Li; Jess G. Fiedorowicz; Lara Boyken; Martin B. Keller. (2010). Arch Gen Psychiatry — Abstract: Longitudinal Course of Bipolar I Disorder: Duration of Mood Episodes. Arch Gen Psychiatry, 67, 339-347.   


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