{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T10:39:35Z","timestamp":1790678375192,"version":"4.1.0"},"reference-count":29,"publisher":"Royal College of Psychiatrists","issue":"2","license":[{"start":{"date-parts":[[2018,1,2]],"date-time":"2018-01-02T00:00:00Z","timestamp":1514851200000},"content-version":"unspecified","delay-in-days":4172,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Br J\n                        Psychiatry"],"published-print":{"date-parts":[[2006,8]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>There have been few detailed longitudinal symptom studies of bipolar\n                           disorder.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To describe the course of bipolar disorder over 18 months in 204 patients\n                           receiving mental healthcare.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>Patients were interviewed every 8 weeks, with weekly ratings of\n                           depression, mania and overall severity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Participants were symptomatic 53% of the time, with sub-syndromal\n                           symptoms present for twice as long as major disorder, and depressive\n                           symptoms three times more than manic symptoms. Individuals who were\n                           experiencing an episode at baseline spent 33% of the 18 months with\n                           substantial sub-syndromal symptoms, 17% with major disorder and 28%\n                           symptom free. Those not experiencing a baseline episode spent twice as\n                           long symptom free and half as long at disorder levels. Changes in symptom\n                           level were frequent. Predictors of sub-syndromal symptoms were similar to\n                           those of major disorder.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Sub-syndromal residual symptoms are an important problem in recurrent\n                           bipolar disorder and require therapeutic intervention.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1192\/bjp.bp.105.013870","type":"journal-article","created":{"date-parts":[[2009,3,6]],"date-time":"2009-03-06T09:58:07Z","timestamp":1236333487000},"page":"118-123","source":"Crossref","is-referenced-by-count":131,"title":["Sub-syndromal and syndromal symptoms in the longitudinal course\n                        of bipolar disorder"],"prefix":"10.1192","volume":"189","author":[{"given":"Eugene 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