title: A bipolar II cohort (ABC): The association of functional disability with gender and rapid cycling.
abstract: BACKGROUND
  Bipolar II disorder (BP II) is a chronic, frequently co-morbid, and complex disorder with similar rates of attempted suicide to BP I. However, case identification for BP II studies that is based on clinician diagnosis alone is prone to error. This paper reports on differences between clinical and research diagnoses and then describes the clinical characteristics of a carefully defined BP II cohort.
  
  
  METHODS
  A cohort of rigorously defined BP II cases were recruited from a range of primary and secondary health services in the North of England to participate in a programme of cross-sectional and prospective studies. Case identification, and rapid cycling, comorbidities and functioning were examined.
  
  
  RESULTS
  Of 355 probable clinical cases of BP II disorder, 176 (∼50%) met rigorous diagnostic criteria. The sample mean age was ∼44 years, with a mean duration of mood disorder of ∼18 years. Two thirds of the cohort were female (n=116), but only 40% were in paid employment. Current and past year functioning was more impaired in females and those with rapid cycling.
  
  
  CONCLUSIONS
  This paper describes only the preliminary assessments of the cohort, so it was not possible to examine additional factors that may contribute to the explained variance in functioning.
  
  
  CONCLUSIONS
  This carefully ascertained cohort of BP II cases show few gender differences, except for levels of functional impairment. Interestingly, the most common problem identified with using case note diagnoses of BP II arose because of failure to record prior episodes of mania, not failure to identify hypomania.
authors.affiliation: Academic Psychiatry, Institute of Neuroscience, Newcastle University, Newcastle Upon Tyne, NE4 5PL UK; Centre for Affective Disorders, IPPN, Kings College, London, UK. Electronic address: jan.scott@newcastle.ac.uk.
authors.forename: Jan
authors.initials: J
authors.lastname: Scott
authors.affiliation: Formerly Institute of Neuroscience, Newcastle University, UK.
authors.forename: Heinz
authors.initials: H
authors.lastname: Grunze
authors.affiliation: Formerly Institute of Neuroscience, Newcastle University, UK.
authors.forename: Thomas D
authors.initials: TD
authors.lastname: Meyer
authors.affiliation: Institute of Neuroscience, Newcastle University, UK.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Nendick
authors.affiliation: Formerly Institute of Neuroscience, Newcastle University, UK.
authors.forename: Hannah
authors.initials: H
authors.lastname: Watkins
authors.affiliation: Institute of Neuroscience, Newcastle University, UK.
authors.forename: Nicol
authors.initials: N
authors.lastname: Ferrier
mesh_terms: D000328:Adult; D001714:Bipolar Disorder / Q000523:psychology*; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003863:Depression / Q000523:psychology; D006233:Persons with Disabilities; D004739:England; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012737:Sex Factors; D013406:Suicide, Attempted
keywords: Bipolar II disorder; Cohort; Functioning; Gender; Rapid cycling