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Table 2 Study characteristics and findings at follow-up

From: Affective lability as a prospective predictor of subsequent bipolar disorder diagnosis: a systematic review

Article FU n % lost at FU FU duration (years) Diagnostic Tool Diagnostic assessor Diagnosed with BD n (%) Rates of BD type Affective lability/BD association
Akiskal et al. 1995 559 NR 11 SADS (DSM /RDC) Clinician 70 (13) 22 BD-I, 48 BD-II BD-II X2 = 19.92 +  +  + 
(specificity = 86%, sensitivity = 42%)
Angst et al. 2003 591 NR 15 DSM-IV criteria Clinician 86 (15) 41 BD-II, 45 BSD BD-II +  + 
BSD OR = 3.4, 95% CI [1.7, 6.6] +  + 
DeGeorge et al. 2014* 112 23% 3.1 (SD = 0.5, range 1.7—4.8) SCID Advanced grad (81%), psychologist + undergrad (19%) 13 (14) BSD and BD
BSD
BSD OR = 2.99 + 
BD OR = .532, CI [.08–3.45]
Sperry et al. 2020* 108 22% 4 (4) PA: OR = 1.91, 95% CI [1.14, 3.18] + 
NA: OR = 1.54, 95% CI [1.00, 2.38] + 
Egeland et al. 2012 221 NR 16 Adapted K-SADS, clinical records Clinician 9 (4) All BD-I Mood lability more present in BD at risk sample than controls (p = 0.063)
Gan et al. 2011 268 22% 1 SCID-I Psychiatrist 27 (24) 2 BD-I, 25 BD-II OR = 0.487 + 
Hafeman et al. 2017 412 14% Mean = 8.34 K-SADS (DSM-IV) Trained interviewers + psychiatrist review 44/299 at-risk (15) 15 BD-I/II, 29 BSD X2 = 4.00 + 
Kochman et al. 2005 80 27% 2–4 (27 months, SD = 9 months) K-SADS Investigator 35 (43) All BSD Prior instability in 64% of BSD; BSD vs non-BSD difference +  +  + 
Ratheesh et al. 2015 52 26% 1 LIFE Unspecified 4 (8) 3 BD-II, 1 BD-NOS SES = 0.27 (p = 0.13), 95% CI [0.00,0.59]
Salvatore et al. 2013 107 79% Mean = 4 SCID Blinded investigator 20 (19) 10 BD-I, 10 BD-NOS RR = 1.45 + 
Tohen et al. 2012 49 13% 4 SCID Blinded experienced raters 14 (33) BD-I or BD-NOS X2 = 4.85 + 
  1. FU  follow-up, n number of, BD bipolar disorder, BPSD bipolar spectrum disorder, DSM Diagnostic and Statistical Manual of Mental Disorders, NR not reported, SADS The Schedule for Affective Disorders and Schizophrenia, RDC the Research Diagnostic Criteria, BPI Bipolar Disorder Type 1, BPII bipolar disorder type 2, DSM-IV the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, BSD bipolar spectrum disorders, OR Odds ratio, CI Confidence intervals, SD standard deviation, SCID Structured Clinical Interviews for DSM, PA positive affect, NA negative affect, K-SADS Kiddie Schedule for Affective Disorders and Schizophrenia, SCID-I Structured Clinical Interview for the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders for Axis I Disorders, LIFE The Longitudinal Interval Follow-up Evaluation for DSM IV, BD-NOS Bipolar disorder not otherwise specified, SES standardised effect size. RR Risk Ratio
  2. *Sperry et al. 2020 and DeGeorge et al. 2014 are two papers from the same study. In both papers ‘% lost at FU’ and ‘FU duration’ are reported for the participant pool including some participants with initial BD diagnoses (we report averages from the total sample, which are expected to be comparable)
  3.  + p < 0.05, +  + p < 0.01, +  +  + p < 0.001