Bipolar disorder with seasonal pattern: clinical characteristics and gender influences.
Bipolar disorder (BD) has a multifactorial etiology with heterogeneous clinical presentations. Around 25% of BD patients may present with a depressive seasonal pattern (SP). However, there are limited scientific data on the prevalence of SP, its clinical manifestations, and any gender influence. Four hundred and fifty-two BD I and II cases (62% female), recruited from three French university-affiliated psychiatric departments, were assessed for SP. Clinical, treatment, and sociodemographic variables were obtained from structured interviews. One hundred and two (23%) cases met DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition) criteria for SP, with similar frequency according to gender. Multivariate analysis showed a significant association between SP and BD II (odds ratio [OR] = 1.99, p = 0.01), lifetime history of rapid cycling (OR = 2.05, p = 0.02), eating disorders (OR = 2.94, p = 0.003), and total number of depressive episodes (OR = 1.13, p = 0.002). Seventy-one percent of cases were correctly classified by this analysis. However, when stratifying the analyses by gender, SP was associated with BD II subtype (OR = 2.89, p = 0.017) and total number of depressive episodes (OR = 1.21, p = 0.0018) in males but with rapid cycling (OR = 3.02, p = 0.0027) and eating disorders (OR = 2.60, p = 0.016) in females. This is the first study to identify different associations between SP and clinical characteristics of BD according to gender. The authors suggest that SP represents a potentially important specifier of BD. These findings indicate that seasonality may reflect increased severity or complexity of disorder.
INSERM, U955, Psychiatrie génétique , Créteil, 94000 , France .
Pierre Alexis
PA
Geoffroy
Frank
F
Bellivier
Jan
J
Scott
Carole
C
Boudebesse
Mohamed
M
Lajnef
Sébastien
S
Gard
Jean-Pierre
JP
Kahn
Jean-Michel
JM
Azorin
Chantal
C
Henry
Marion
M
Leboyer
Bruno
B
Etain
D000328:Adult; D001714:Bipolar Disorder / Q000150:complications / Q000453:epidemiology*; D002940:Circadian Rhythm; D001068:Feeding and Eating Disorders / Q000150:complications / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016011:Normal Distribution; D016017:Odds Ratio; D015995:Prevalence; D011569:Psychiatric Status Rating Scales; D012044:Regression Analysis; D012621:Seasons; D012737:Sex Factors; D012923:Social Class; D013997:Time Factors; D055815:Young Adult