Table 3.
Symptoms and Signs During the Bipolar Mania Prodrome (n, %)
| Bipolar Prodrome Symptom/Sign (≥Moderate Severity) | Mania With Psychosis (n = 34) | Mania Without Psychosis (n = 18) | P Value |
| Subsyndromal manic symptoms | |||
| Irritability or easily angered | 21 (61.8) | 11 (61.1) | .96 |
| Racing thoughts | 22 (64.7) | 9 (50.0) | .30 |
| Increased energy or goal-directed activity | 22 (64.7) | 4 (22.2) | .0036 |
| Overly talkative | 16 (47.1) | 6 (33.3) | .34 |
| Reckless or dangerous behavior | 16 (47.1) | 5 (27.8) | .18 |
| Decreased need for sleep | 14 (41.2) | 6 (33.3) | .58 |
| Overly cheerful or happy | 13 (38.2) | 5 (27.8) | .45 |
| Overly self confident | 8 (23.5) | 4 (22.2) | .91 |
| Increased sexual energy | 8 (23.5) | 2 (11.1) | .28 |
| Risky sexual behavior | 1 (2.9) | 2 (11.1) | .23 |
| Subsyndromal manic or depressive symptoms | |||
| Decreased concentration/attention/memory | 20 (58.8) | 7 (38.9) | .17 |
| Physically agitated | 19 (55.9) | 6 (33.3) | .12 |
| Subsyndromal manic or psychotic symptoms | |||
| Grandiose ideas | 8 (23.5) | 0 (0.0) | .021 |
| Subsyndromal psychotic symptoms | |||
| Strange or unusual (nongrandiose) ideas | 10 (29.4) | 0 (0.0) | .010 |
| Suspiciousness | 12 (35.3) | 0 (0.0) | .0041 |
| Hallucinatory experiences | 11 (32.3) | 1 (5.6) | .029 |
| Subsyndromal manic or psychotic or depressive symptoms | |||
| Difficulty thinking or communicating clearly | 13 (38.2) | 8 (44.4) | .66 |
| Subsyndromal depressive symptoms | |||
| Depressed mood | 18 (52.9) | 10 (55.6) | .86 |
| Anhedonia | 17 (50.0) | 4 (22.2) | .052 |
| Insomnia | 14 (41.2) | 5 (27.8) | .34 |
| Feeling worthless or guilty | 13 (38.2) | 4 (22.2) | .24 |
| Thinking about suicide | 10 (29.4) | 6 (33.3) | .77 |
| Tiredness or lack of energy | 9 (26.5) | 4 (22.2) | .74 |
| Weight loss or decrease in appetite | 10 (29.4) | 2 (11.1) | .14 |
| Physically slowed down | 4 (11.8) | 4 (22.2) | .32 |
| Weight gain or increase in appetite | 4 (11.8) | 3 (16.7) | .62 |
| Attempting suicide | 4 (11.8) | 2 (11.1) | .94 |
| Hypersomnia | 1 (2.9) | 2 (11.1) | .23 |
| General psychopathology | |||
| Decreased school or work functioning | 24 (70.62) | 10 (55.6) | .28 |
| Frequent mood swings/lability | 21 (61.8) | 9 (50.0) | .41 |
| Anger or losing temper a lot | 15 (44.1) | 10 (55.6) | .43 |
| Social isolation | 13 (38.2) | 10 (55.6) | .23 |
| Anxiety or nervousness | 16 (47.1) | 6 (33.3) | .30 |
| Oppositionality | 10 (29.4) | 9 (50.0) | .14 |
| Obsessions or compulsions | 10 (29.4) | 4 (22.2) | .58 |
| Ambivalence | 9 (26.5) | 2 (11.1) | .20 |