{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T04:05:24Z","timestamp":1782273924824,"version":"3.54.5"},"reference-count":67,"publisher":"Cambridge University Press (CUP)","issue":"13","license":[{"start":{"date-parts":[[2018,10,17]],"date-time":"2018-10-17T00:00:00Z","timestamp":1539734400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Psychol. Med."],"published-print":{"date-parts":[[2019,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec id=\"S003329171800301X_sec_a1\"><jats:title>Background<\/jats:title><jats:p>Given its diverse disease courses and symptom presentations, multiple phenotype dimensions with different biological underpinnings are expected with bipolar disorders (BPs). In this study, we aimed to identify lifetime BP psychopathology dimensions. We also explored the differing associations with bipolar I (BP-I) and bipolar II (BP-II) disorders.<\/jats:p><\/jats:sec><jats:sec id=\"S003329171800301X_sec_a2\" sec-type=\"methods\"><jats:title>Methods<\/jats:title><jats:p>We included a total of 307 subjects with BPs in the analysis. For the factor analysis, we chose six variables related to clinical courses, 29 indicators covering lifetime symptoms of mood episodes, and 6 specific comorbid conditions. To determine the relationships among the identified phenotypic dimensions and their effects on differentiating BP subtypes, we applied structural equation modeling.<\/jats:p><\/jats:sec><jats:sec id=\"S003329171800301X_sec_a3\" sec-type=\"results\"><jats:title>Results<\/jats:title><jats:p>We selected a six-factor solution through scree plot, Velicer's minimum average partial test, and face validity evaluations; the six factors were cyclicity, depression, atypical vegetative symptoms, elation, psychotic\/irritable mania, and comorbidity. In the path analysis, five factors excluding atypical vegetative symptoms were associated with one another. Cyclicity, depression, and comorbidity had positive associations, and they correlated negatively with psychotic\/irritable mania; elation showed positive correlations with cyclicity and psychotic\/irritable mania. Depression, cyclicity, and comorbidity were stronger in BP-II than in BP-I, and they contributed significantly to the distinction between the two disorders.<\/jats:p><\/jats:sec><jats:sec id=\"S003329171800301X_sec_a4\" sec-type=\"conclusion\"><jats:title>Conclusions<\/jats:title><jats:p>We identified six phenotype dimensions; in addition to symptom features of manic and depressive episodes, various comorbidities and high cyclicity constructed separate dimensions. Except for atypical vegetative symptoms, all factors showed a complex interdependency and played roles in discriminating BP-II from BP-I.<\/jats:p><\/jats:sec>","DOI":"10.1017\/s003329171800301x","type":"journal-article","created":{"date-parts":[[2018,10,17]],"date-time":"2018-10-17T07:54:06Z","timestamp":1539762846000},"page":"2177-2185","source":"Crossref","is-referenced-by-count":12,"title":["Psychopathologic structure of bipolar disorders: exploring dimensional phenotypes, their relationships, and their associations with bipolar I and II disorders"],"prefix":"10.1017","volume":"49","author":[{"given":"Ji Hyun","family":"Baek","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyooseob","family":"Ha","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yongkang","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Young-ah","family":"Cho","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"So Yung","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yujin","family":"Choi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sung-Lee","family":"Jang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taesung","family":"Park","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tae Hyon","family":"Ha","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyung Sue","family":"Hong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2018,10,17]]},"reference":[{"key":"S003329171800301X_ref28","doi-asserted-by":"publisher","DOI":"10.1016\/j.comppsych.2004.02.007"},{"key":"S003329171800301X_ref66","doi-asserted-by":"publisher","DOI":"10.1016\/S0165-1781(00)00228-6"},{"key":"S003329171800301X_ref18","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1186\/s13011-016-0078-x","article-title":"Comparison of illegal drug use pattern in Taiwan and Korea from 2006 to 2014","volume":"11","author":"Feng","year":"2016","journal-title":"Substance Abuse Treatment, Prevention, and Policy"},{"key":"S003329171800301X_ref24","doi-asserted-by":"publisher","DOI":"10.1186\/1471-244X-11-137"},{"key":"S003329171800301X_ref38","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.163.2.240"},{"key":"S003329171800301X_ref21","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0053804"},{"key":"S003329171800301X_ref61","doi-asserted-by":"publisher","DOI":"10.1037\/0021-9010.74.5.728"},{"key":"S003329171800301X_ref46","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291715000185"},{"key":"S003329171800301X_ref2","doi-asserted-by":"publisher","DOI":"10.1016\/S0165-0327(02)00318-X"},{"key":"S003329171800301X_ref55","doi-asserted-by":"publisher","DOI":"10.1038\/mp.2013.138"},{"key":"S003329171800301X_ref16","doi-asserted-by":"publisher","DOI":"10.1016\/0165-0327(85)90068-0"},{"key":"S003329171800301X_ref65","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2011.11.046"},{"key":"S003329171800301X_ref19","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2017.09.032"},{"key":"S003329171800301X_ref40","doi-asserted-by":"publisher","DOI":"10.3109\/07420528.2014.899244"},{"key":"S003329171800301X_ref22","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2008.10.021"},{"key":"S003329171800301X_ref47","doi-asserted-by":"publisher","DOI":"10.1016\/j.biopsych.2005.01.036"},{"key":"S003329171800301X_ref10","doi-asserted-by":"publisher","DOI":"10.1016\/S0165-0327(02)00333-6"},{"key":"S003329171800301X_ref12","doi-asserted-by":"publisher","DOI":"10.1038\/tp.2016.242"},{"key":"S003329171800301X_ref20","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.1982.04290100031006"},{"key":"S003329171800301X_ref50","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2012.10.005"},{"key":"S003329171800301X_ref37","doi-asserted-by":"publisher","DOI":"10.1159\/000109953"},{"key":"S003329171800301X_ref35","doi-asserted-by":"publisher","DOI":"10.1038\/ejhg.2012.67"},{"key":"S003329171800301X_ref39","doi-asserted-by":"publisher","DOI":"10.1016\/j.schres.2012.03.032"},{"key":"S003329171800301X_ref5","doi-asserted-by":"publisher","DOI":"10.1016\/j.comppsych.2014.02.012"},{"key":"S003329171800301X_ref8","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1080\/15402002.2014.974179","article-title":"Lifetime characteristics of evening-preference and irregular bed-rise time are associated with lifetime seasonal variation of mood and behavior: comparison between individuals with bipolar disorder and healthy controls","volume":"14","author":"Baek","year":"2016","journal-title":"Behavioral Sleep Medicine"},{"key":"S003329171800301X_ref48","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.161.2.255"},{"key":"S003329171800301X_ref36","doi-asserted-by":"publisher","DOI":"10.1186\/s12888-016-0831-8"},{"key":"S003329171800301X_ref49","doi-asserted-by":"publisher","DOI":"10.1186\/s40345-015-0026-0"},{"key":"S003329171800301X_ref59","doi-asserted-by":"publisher","DOI":"10.1097\/01.jcp.0000138772.40515.70"},{"key":"S003329171800301X_ref25","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2012.09.016"},{"key":"S003329171800301X_ref57","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.159.6.968"},{"key":"S003329171800301X_ref32","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0028477"},{"key":"S003329171800301X_ref6","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2010.11.020"},{"key":"S003329171800301X_ref41","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.158.3.420"},{"key":"S003329171800301X_ref4","volume-title":"Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision (DSM-IV-TR)","year":"2000"},{"key":"S003329171800301X_ref13","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2010.07.030"},{"key":"S003329171800301X_ref54","volume-title":"Seasonal Pattern Assessment Questionnaire","author":"Rosenthal","year":"1987"},{"key":"S003329171800301X_ref30","doi-asserted-by":"publisher","DOI":"10.1017\/S1461145703003341"},{"key":"S003329171800301X_ref62","doi-asserted-by":"publisher","DOI":"10.1001\/archgenpsychiatry.2010.15"},{"key":"S003329171800301X_ref64","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.2012.12030301"},{"key":"S003329171800301X_ref56","first-page":"S96","article-title":"The treatment of anxiety states and atypical depressions by the monoamine oxidase inhibitor drugs","volume":"3","author":"Sargant","year":"1962","journal-title":"Journal of Neuropsychiatry"},{"key":"S003329171800301X_ref43","doi-asserted-by":"publisher","DOI":"10.1001\/archgenpsychiatry.2009.56"},{"key":"S003329171800301X_ref33","doi-asserted-by":"publisher","DOI":"10.1001\/archgenpsychiatry.2010.180"},{"key":"S003329171800301X_ref11","doi-asserted-by":"publisher","DOI":"10.1111\/bdi.12527"},{"key":"S003329171800301X_ref67","first-page":"122","article-title":"A preliminary study on the Korean translation of composite scale to measure morningness-eveningness","volume":"36","author":"Yoon","year":"1997","journal-title":"Journal of Korean Neuropsychiatric Association"},{"key":"S003329171800301X_ref45","doi-asserted-by":"publisher","DOI":"10.1038\/mp.2013.116"},{"key":"S003329171800301X_ref7","doi-asserted-by":"publisher","DOI":"10.1002\/da.22261"},{"key":"S003329171800301X_ref51","doi-asserted-by":"publisher","DOI":"10.1016\/j.biopsych.2004.01.022"},{"key":"S003329171800301X_ref9","doi-asserted-by":"crossref","first-page":"510","DOI":"10.1001\/archpsyc.58.5.510","article-title":"Admixture analysis of age at onset in bipolar I affective disorder","volume":"58","author":"Bellivier","year":"2001","journal-title":"Archives of General Psychiatry"},{"key":"S003329171800301X_ref1","doi-asserted-by":"publisher","DOI":"10.1186\/s40345-017-0093-5"},{"key":"S003329171800301X_ref3","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1016\/S0165-0327(02)00320-8","article-title":"Bipolar II with and without cyclothymic temperament: \u2018dark\u2019 and \u2018sunny\u2019 expressions of soft bipolarity","volume":"73","author":"Akiskal","year":"2003","journal-title":"Journal of Affective Disorders"},{"key":"S003329171800301X_ref58","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1002\/(SICI)1520-6394(1998)8:2<80::AID-DA6>3.0.CO;2-I","article-title":"Analysis of depressive symptomatology in mood disorders","volume":"8","author":"Serretti","year":"1998","journal-title":"Depression and Anxiety"},{"key":"S003329171800301X_ref44","doi-asserted-by":"publisher","DOI":"10.1038\/tp.2012.81"},{"key":"S003329171800301X_ref17","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2004.05.015"},{"key":"S003329171800301X_ref34","doi-asserted-by":"publisher","DOI":"10.1016\/j.psychres.2014.11.051"},{"key":"S003329171800301X_ref52","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-5618.2009.00764.x"},{"key":"S003329171800301X_ref31","doi-asserted-by":"publisher","DOI":"10.1016\/S0010-440X(03)00089-0"},{"key":"S003329171800301X_ref15","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1016\/j.comppsych.2017.04.005","article-title":"Lifetime presence of psychotic symptoms in bipolar disorder is associated with less favorable socio-demographic and certain clinical features","volume":"76","author":"Dell'Osso","year":"2017","journal-title":"Comprehensive Psychiatry"},{"key":"S003329171800301X_ref26","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0175299"},{"key":"S003329171800301X_ref60","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.161.12.2222"},{"key":"S003329171800301X_ref53","doi-asserted-by":"publisher","DOI":"10.1111\/bdi.12538"},{"key":"S003329171800301X_ref27","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.2010.09091379"},{"key":"S003329171800301X_ref23","first-page":"362","article-title":"Development of Korean version of structured clinical interview schedule for DSM-IV axis I disorder: interrater reliability","volume":"39","author":"Han","year":"2000","journal-title":"Journal of Korean Neuropsychiatric Association"},{"key":"S003329171800301X_ref29","doi-asserted-by":"publisher","DOI":"10.1016\/S0165-0327(02)00324-5"},{"key":"S003329171800301X_ref14","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1176\/ajp.151.2.199","article-title":"The long-term stability of depressive subtypes","volume":"151","author":"Coryell","year":"1994","journal-title":"American Journal of Psychiatry"},{"key":"S003329171800301X_ref63","doi-asserted-by":"publisher","DOI":"10.1016\/S0165-0327(01)00432-3"},{"key":"S003329171800301X_ref42","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2015.11.010"}],"container-title":["Psychological Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S003329171800301X","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,12,15]],"date-time":"2020-12-15T14:38:13Z","timestamp":1608043093000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S003329171800301X\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,10,17]]},"references-count":67,"journal-issue":{"issue":"13","published-print":{"date-parts":[[2019,10]]}},"alternative-id":["S003329171800301X"],"URL":"https:\/\/doi.org\/10.1017\/s003329171800301x","relation":{},"ISSN":["0033-2917","1469-8978"],"issn-type":[{"value":"0033-2917","type":"print"},{"value":"1469-8978","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,10,17]]}}}