Psychiatric and clinical correlates of rapid cycling bipolar disorder: a cross-sectional study.
Rapid cycling (RC) is a feature of bipolar disorder (BD) that has been associated with worse outcome and more severe disability. Our goal was to investigate the association of demographic and clinical factors with RC.
We compared RC and non-rapid cycling (NRC) BD patients from the Brazilian Research Network in Bipolar Disorder (BRN-BD) regarding age at onset of BD; total number of episodes; previous number of manic, depressive, mixed, and hypomanic episodes; polarity of the first episode; gender; number of suicide attempts; number of lifetime hospitalizations and lifetime history of at least one hospitalization; family history of mood disorder; clinical comorbidities such as hypothyroidism, hyperthyroidism, seizures; and current use of medications such as lithium, anticonvulsants, antipsychotics, and antidepressants.
We studied 577 patients and found that 100 (17.3%) met the criteria for RC in the year before the investigation. RC patients had earlier age at onset, longer duration of disease, more lifetime depressive and manic episodes, higher number of suicide attempts, and higher rate antidepressant use.
The presence of RC in the previous year was associated with specific clinical characteristics closely related to worse outcome in the course of BD.
Programa de Transtorno Bipolar (PROMAN), Departamento de Psiquiatria, Faculdade de Medicina, Universidade de São Paulo (USP), São Paulo, SP, Brazil.
Alexandre D
AD
Gigante
Programa de Transtorno Bipolar (PROMAN), Departamento de Psiquiatria, Faculdade de Medicina, Universidade de São Paulo (USP), São Paulo, SP, Brazil.
Ivan Y
IY
Barenboim
Programa de Transtorno Bipolar (PROMAN), Departamento de Psiquiatria, Faculdade de Medicina, Universidade de São Paulo (USP), São Paulo, SP, Brazil.
Rodrigo da S
RD
Dias
Programa de Transtorno Bipolar (PROMAN), Departamento de Psiquiatria, Faculdade de Medicina, Universidade de São Paulo (USP), São Paulo, SP, Brazil.
Ricardo A
RA
Toniolo
Insper Instituto de Ensino e Pesquisa, São Paulo, SP, Brazil.
Tiago
T
Mendonça
Centro de Estudos de Transtornos de Humor e Ansiedade (CETHA), Departamento de Psiquiatria, Universidade Federal da Bahia (UFBA), Salvador, BA, Brazil.
Ângela
Â
Miranda-Scippa
Programa de Atendimento do Transtorno de Humor Bipolar (PROTAHBI), Departamento de Psiquiatria, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil.
Flávio
F
Kapczinski
Programa de Transtorno Bipolar (PROMAN), Departamento de Psiquiatria, Faculdade de Medicina, Universidade de São Paulo (USP), São Paulo, SP, Brazil.
Beny
B
Lafer
D000328:Adult; D017668:Age of Onset; D000928:Antidepressive Agents / Q000627:therapeutic use; D001714:Bipolar Disorder / Q000188:drug therapy / Q000453:epidemiology / Q000503:physiopathology / Q000523:psychology*; D001938:Brazil / Q000453:epidemiology; D015897:Comorbidity; D004812:Epidemiologic Methods; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D013406:Suicide, Attempted / Q000523:psychology / Q000706:statistics & numerical data
D000928:Antidepressive Agents