Contribution of depressive symptom load on prediction of transition to bipolar disorders: Results from the prospective-longitudinal multi-method Early-BipoLife study

Petersen T, Martini J, Bauer M, Bechdolf A, Bermpohl F, Berndt C, Bröckel-Bundt KL, Sperling T, Correll CU, Dannlowski U, Falkenberg I, Fallgatter AJ, Fusar-Poli P, Jansen A, Juckel G, Kircher T, Kittel-Schneider S, Krüger-Özgürdal S, Lambert M, Leopold K, Maicher B, Matura S, Mennigen E, Reif A, Ritter P, Sauer C, Stamm T, Pfennig A (2026)

Publication Type: Journal article

Publication year: 2026

Journal

Journal of Affective Disorders Elsevier

Book Volume: 403

Article Number: 121419

DOI: 10.1016/j.jad.2026.121419

Abstract

Background Depressive episodes are associated with a higher risk for the onset of bipolar disorder (BD). This study investigates the contribution of specific depressive symptoms using a multi-method approach in persons at-risk for bipolar disorders. Methods In the Early-BipoLife study, N = 1083 participants at risk for BD were examined over two years (baseline, 6, 12, 18, and 24 months). Out of 1083 participants, N = 57 (5.3%) transitioned to BD and/or were prescribed with a mood stabilizing medication (lithium, lamotrigine, valproic acid, carbamazepine, quetiapine). At baseline, N = 880 participants met the diagnostic criteria for lifetime major depression (lifetime MD) (SCID). Depressive symptoms were recorded using diagnostic interviews (EPI bipolar , SCID), a clinician rating (ICD-C) and a self-rating (QIDS-SR16). Binary logistic regressions were calculated to assess the prospective association between depressive symptoms and transition/prescription of a mood stabilizing medication. Results Compared to ‘no lifetime MD’, ‘lifetime MD’ were at higher risk for transition and/or prescription of a mood stabilizing medication (OR = 2.87, 95%CI: 1.03–8.04). A higher QIDS-SR16 symptom load was associated with transition and/or prescription of a mood stabilizing medication (OR = 1.07, 95%CI: 1.01–1.13). Consistently and across methods, it was shown that suicidality at baseline predicted transition to BD and/or prescription of a mood stabilizing medication. Further baseline symptoms assessed by the clinicians (IDS-C), such as decreased or increased appetite and quality of mood were also predictive for this outcome. Conclusion Depressive symptom load and suicidality were robust predictors for BD. Clinician judgment can provide important information for early detection of BD.

Involved external institutions

Universitätsklinikum Carl Gustav Carus Dresden DE Germany (DE) Charité - Universitätsmedizin Berlin DE Germany (DE) Westfälische Wilhelms-Universität (WWU) Münster DE Germany (DE) Universitätsklinikum Gießen und Marburg (UKGM) DE Germany (DE) Universitätsklinikum Tübingen DE Germany (DE) King’s College London GB United Kingdom (GB) Universitätsklinikum Frankfurt am Main (KGU) DE Germany (DE) Universitätsklinikum Bonn DE Germany (DE) Universitätsklinikum Hamburg-Eppendorf (UKE) DE Germany (DE) Vivantes - Netzwerk für Gesundheit GmbH DE Germany (DE)

How to cite

APA:

Petersen, T., Martini, J., Bauer, M., Bechdolf, A., Bermpohl, F., Berndt, C.,... Pfennig, A. (2026). Contribution of depressive symptom load on prediction of transition to bipolar disorders: Results from the prospective-longitudinal multi-method Early-BipoLife study. Journal of Affective Disorders, 403. https://doi.org/10.1016/j.jad.2026.121419

MLA:

Petersen, Thore, et al. "Contribution of depressive symptom load on prediction of transition to bipolar disorders: Results from the prospective-longitudinal multi-method Early-BipoLife study." Journal of Affective Disorders 403 (2026).

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