Clinical features that can appear many years ahead of a psychiatric diagnosis may help doctors to predict whether patients will develop bipolar disorder or unipolar depression, say researchers.

“The need for such differential prognosis is commonly encountered clinically, particularly in young patients,” observe Ross Baldessarini (McLean Hospital, Belmont, Massachusetts) and study co-authors.

Many of the antecedents appeared during childhood. For example, in semi-structured clinical interviews, 6.5% of 215 patients with bipolar disorder recalled having phobia between the ages of 1 and 12 years, whereas none of the 119 patients with unipolar depression did so.

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