title: A re-examination of antidepressant treatment-emergent mania in bipolar disorders: evidence of gender differences.
abstract: OBJECTIVE
  To explore the prevalence and clinical profile of males and females who develop antidepressant treatment-emergent mania (ATEM).
  
  
  METHODS
  From an original sample of 754 patients with BD, we identified ATEM+ cases (n = 75) and ATEM- controls (n = 135) that met stringent criteria. We specifically examined the combinations of clinical factors that best classified males and females as ATEM+ cases.
  
  
  RESULTS
  Seventy-five individuals were classified as ATEM+; 87% of ATEM events occurred during antidepressant monotherapy. Regression analyses demonstrated that the presence of an alcohol and/or substance use disorder [Odds Ratio (OR) 6.37], a history of one or more suicide attempts (OR 4.19) and higher number of depressive episodes per year of illness (OR 1.71) correctly classified 73% of males. In contrast, 84% of females were correctly classified on the basis of a positive history of thyroid disorder (OR 3.23), a positive family history of BD I (OR 2.68) and depressive onset polarity (OR 2.01).
  
  
  CONCLUSIONS
  Using stringent definitions of ATEM status to reduce the probability of inclusion of false-positive cases and false-negative controls, we identified for the first time that the risk profiles for the development of an ATEM differ significantly according to gender.
authors.affiliation: Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK.|Centre for Affective Disorders, IoPPN, Kings College, London, UK.
authors.forename: J
authors.identifier: http://orcid.org/0000-0002-7203-8601
authors.initials: J
authors.lastname: Scott
authors.affiliation: Groupe Hospitalier Saint-Louis-Lariboisière-Fernand Widal, AP-HP, Paris, France.|INSERM, Unité UMR-S 1144, Variabilité de Réponse aux Psychotropes, Université Paris Descartes-Paris Diderot, Paris, France.|Université Paris Diderot, Paris, France.
authors.forename: C
authors.initials: C
authors.lastname: Brichant-Petitjean
authors.affiliation: Groupe Henri Mondor-Albert Chenevier, Pôle de Psychiatrie, AP-HP, Créteil, France.|Unité 955, Equipe de Psychiatrie Translationnelle, IMRB, INSERM, Créteil, France.|Faculté de Médecine, IFR10, Université Paris Est Créteil, Créteil, France.|Fondation FondaMental, Créteil, France.
authors.forename: B
authors.identifier: http://orcid.org/0000-0002-5377-1488
authors.initials: B
authors.lastname: Etain
authors.affiliation: Groupe Henri Mondor-Albert Chenevier, Pôle de Psychiatrie, AP-HP, Créteil, France.|Unité 955, Equipe de Psychiatrie Translationnelle, IMRB, INSERM, Créteil, France.|Faculté de Médecine, IFR10, Université Paris Est Créteil, Créteil, France.|Fondation FondaMental, Créteil, France.|Unité Perception et Mémoire, Institut Pasteur, Paris, France.
authors.forename: C
authors.initials: C
authors.lastname: Henry
authors.affiliation: Fondation FondaMental, Créteil, France.|Service de Psychiatrie et Psychologie Clinique, Centre Psychothérapique de Nancy et CHU de Nancy, Vandoeuvre les Nancy, France.|Université de Lorraine, Nancy, France.
authors.forename: J-P
authors.initials: JP
authors.lastname: Kahn
authors.affiliation: Fondation FondaMental, Créteil, France.|AP-HM, Pôle de psychiatrie, Hôpital Sainte Marguerite, Marseille, France.
authors.forename: J-M
authors.initials: JM
authors.lastname: Azorin
authors.affiliation: Groupe Henri Mondor-Albert Chenevier, Pôle de Psychiatrie, AP-HP, Créteil, France.|Unité 955, Equipe de Psychiatrie Translationnelle, IMRB, INSERM, Créteil, France.|Faculté de Médecine, IFR10, Université Paris Est Créteil, Créteil, France.|Fondation FondaMental, Créteil, France.
authors.forename: M
authors.initials: M
authors.lastname: Leboyer
authors.affiliation: Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK.|Centre for Affective Disorders, IoPPN, Kings College, London, UK.|Groupe Hospitalier Saint-Louis-Lariboisière-Fernand Widal, AP-HP, Paris, France.|Fondation FondaMental, Créteil, France.
authors.forename: F
authors.identifier: http://orcid.org/0000-0002-3660-6640
authors.initials: F
authors.lastname: Bellivier
mesh_terms: D000293:Adolescent; D000328:Adult; D000928:Antidepressive Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001714:Bipolar Disorder / Q000188:drug therapy / Q000523:psychology*; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D008297:Male; D011569:Psychiatric Status Rating Scales; D012044:Regression Analysis; D012727:Sex Characteristics; D055815:Young Adult
chemical_list: D000928:Antidepressive Agents
keywords: antidepressant treatment-emergent mania; antidepressant-induced mania; bipolar disorder; clinical predictors; depression; gender; thyroid disease; treatment-emergent affective switch