title: Seasonality of Admissions for Mania: Results From a General Hospital Psychiatric Unit in Pondicherry, India.
abstract: BACKGROUND
  Bipolar disorder is affected by variables that modulate circadian rhythm, including seasonal variations. There is evidence of a seasonal pattern of admissions of mania in various geographical settings, though its timing varies by region and climate. Variables such as age and gender have been shown to affect seasonality in some studies.
  
  
  METHODS
  Data on monthly admission patterns for mania at a general hospital psychiatry unit in Pondicherry, India, were collected for 4 years (2010-2013) and analyzed for seasonality and seasonal peaks. The effects of age and gender were analyzed separately.
  
  
  RESULTS
  There was overall evidence of a seasonal pattern of admissions for mania (P < .01, Friedman test for seasonality), with a peak beginning during the rainy season and ending before summer (P < .0.1, Ratchet circular scan test). Male sex (P < .005, Ratchet circular scan test) and age > 25 years (P < .005, Ratchet circular scan test) were specifically associated with this seasonal peak.
  
  
  CONCLUSIONS
  The effect of seasons on mania is complex and is modulated by a variety of variables. Our study is consistent with earlier research findings: a greater degree of seasonality for mania in men. It is possible that climatic and individual variables interact to determine seasonal patterns in bipolar disorder in a given setting.
authors.affiliation: Department of Psychiatry, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry, India.
authors.forename: Ravi Philip
authors.initials: RP
authors.lastname: Rajkumar
authors.affiliation: Department of Psychiatry, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry, India.
authors.forename: Siddharth
authors.initials: S
authors.lastname: Sarkar