Massimiliano Buoli1, Bernardo Dell'Osso2, Alice Caldiroli3, Greta Silvia Carnevali3, Marta Serati3, Trisha Suppes4, Terence A Ketter4, A Carlo Altamura3. 1. Department of Psychiatry, University of Milan, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico Via F. Sforza 35, 20122 Milan, Italy. Electronic address: massimiliano.buoli@hotmail.it. 2. Department of Psychiatry, University of Milan, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico Via F. Sforza 35, 20122 Milan, Italy; Department of Psychiatry and Behavioral Sciences, Stanford University, School of Medicine, Stanford, CA, USA. 3. Department of Psychiatry, University of Milan, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico Via F. Sforza 35, 20122 Milan, Italy. 4. Department of Psychiatry and Behavioral Sciences, Stanford University, School of Medicine, Stanford, CA, USA.
Abstract
BACKGROUND: Rapid cycling (RC) worsens the course of bipolar disorder (BD) being associated with poor response to pharmacotherapy. Previous studies identified clinical variables potentially associated with RCBD: however, in many cases, results were discordant or unreplicated. The present study was aimed to compare clinical variables between RC and non RC bipolar patients and to identify related risk factors. METHODS: A sample of 238 bipolar patients was enrolled from 3 different community mental health centers. Descriptive analyses were performed on total sample, and patients were compared in terms of socio-demographic and clinical variables according to the presence of RC by multivariate analyses of variance (MANOVAs, continuous variables) or χ2 tests (qualitative variables). Binary logistic regression was performed to calculate odds ratios. RESULTS: Twenty-eight patients (11.8%) had RC. The two groups were not different in terms of age, age at onset, gender distribution, type of family history, type of substance use disorder, history of antidepressant therapy, main antidepressant, psychotic symptoms, comorbid anxiety disorders, suicide attempts, thyroid diseases, diabetes, type of BD, duration of untreated illness, illness duration, duration of antidepressant treatment and GAF scores. In contrast, RC patients had more often a history of obstetric complications (p<0.05), obesity (p<0.05) and a trend to hypercholesterolemia (p=0.08). In addition, RC bipolar patients presented more frequently lifetime MDMA misuse (p<0.05) than patients without RC. DISCUSSION: Findings from the present study seem to indicate that obesity and obstetric complications are risk factors for the development of RC in BD. In addition, lifetime MDMA misuse may be more frequent in RC bipolar patients.
BACKGROUND: Rapid cycling (RC) worsens the course of bipolar disorder (BD) being associated with poor response to pharmacotherapy. Previous studies identified clinical variables potentially associated with RCBD: however, in many cases, results were discordant or unreplicated. The present study was aimed to compare clinical variables between RC and non RC bipolarpatients and to identify related risk factors. METHODS: A sample of 238 bipolarpatients was enrolled from 3 different community mental health centers. Descriptive analyses were performed on total sample, and patients were compared in terms of socio-demographic and clinical variables according to the presence of RC by multivariate analyses of variance (MANOVAs, continuous variables) or χ2 tests (qualitative variables). Binary logistic regression was performed to calculate odds ratios. RESULTS: Twenty-eight patients (11.8%) had RC. The two groups were not different in terms of age, age at onset, gender distribution, type of family history, type of substance use disorder, history of antidepressant therapy, main antidepressant, psychotic symptoms, comorbid anxiety disorders, suicide attempts, thyroid diseases, diabetes, type of BD, duration of untreated illness, illness duration, duration of antidepressant treatment and GAF scores. In contrast, RC patients had more often a history of obstetric complications (p<0.05), obesity (p<0.05) and a trend to hypercholesterolemia (p=0.08). In addition, RC bipolarpatients presented more frequently lifetime MDMA misuse (p<0.05) than patients without RC. DISCUSSION: Findings from the present study seem to indicate that obesity and obstetric complications are risk factors for the development of RC in BD. In addition, lifetime MDMA misuse may be more frequent in RC bipolarpatients.
Authors: Ana S Yamagata; Lucas B Rizzo; Raphael O Cerqueira; Janine Scott; Quirino Cordeiro; Roger S McIntyre; Rodrigo B Mansur; Elisa Brietzke Journal: Mol Neuropsychiatry Date: 2018-02-01
Authors: Massimiliano Buoli; Bruno Mario Cesana; Simone Bolognesi; Andrea Fagiolini; Umberto Albert; Gabriele Di Salvo; Giuseppe Maina; Andrea de Bartolomeis; Maurizio Pompili; Claudia Palumbo; Emi Bondi; Luca Steardo; Pasquale De Fazio; Mario Amore; Mario Altamura; Antonello Bellomo; Alessandro Bertolino; Marco Di Nicola; Guido Di Sciascio; Andrea Fiorillo; Emilio Sacchetti; Gabriele Sani; Alberto Siracusano; Giorgio Di Lorenzo; Alfonso Tortorella; A Carlo Altamura; Bernardo Dell'Osso Journal: Eur Arch Psychiatry Clin Neurosci Date: 2021-10-15 Impact factor: 5.270