Masaki Kato1, Naoto Adachi2, Yukihisa Kubota2, Takaharu Azekawa2, Hitoshi Ueda2, Kouji Edagawa2, Eiichi Katsumoto2, Eiichiro Goto2, Seiji Hongo2, Takashi Tsuboi3, Norio Yasui-Furukori4, Reiji Yoshimura5, Atsuo Nakagawa6, Toshiaki Kikuchi6, Toshihiko Kinoshita7, Youichiro Watanabe2, Kazuhira Miki2, Koichiro Watanabe3. 1. Department of Neuropsychiatry, Kansai Medical University, Osaka, Japan; The Japanese Society of Clinical Neuropsychopharmacology, Tokyo, Japan. Electronic address: katom@takii.kmu.ac.jp. 2. The Japanese Association of Neuro-Psychiatric Clinics, Tokyo, Japan. 3. The Japanese Society of Clinical Neuropsychopharmacology, Tokyo, Japan; Department of Neuropsychiatry, Kyorin University School of Medicine, Tokyo, Japan. 4. The Japanese Society of Clinical Neuropsychopharmacology, Tokyo, Japan; Department of Psychiatry, Dokkyo Medical University, Tochigi, Japan. 5. The Japanese Society of Clinical Neuropsychopharmacology, Tokyo, Japan; Department of Psychiatry, University of Occupational and Environmental Health, Fukuoka, Japan. 6. The Japanese Society of Clinical Neuropsychopharmacology, Tokyo, Japan; Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan. 7. Department of Neuropsychiatry, Kansai Medical University, Osaka, Japan; The Japanese Society of Clinical Neuropsychopharmacology, Tokyo, Japan.
Abstract
OBJECTIVE: Rapid cycling (RC) presents a risk of greater severity in bipolar disorder (BD), whereas patients with one-year euthymia (OYE) have better prognosis. The purpose of this study was to identify the clinical background and prescription characteristics of patients in the two opposing states of current RC and OYE from a large sample (N = 2609) in a multicenter treatment survey on BD in psychiatric clinics (MUSUBI). METHODS: MUSIBI was a cross-sectional study wherein questionnaires, based on a retrospective medical record survey of consecutive cases of BD, were distributed to 176 outpatient clinics. The questionnaire collected information on patient background, current episode, and clinical and prescription characteristics. OYE was defined as the presence of a euthymic state for at least 12 months. RESULTS: In this study, current RC (9.7% frequency) was significantly higher in females, had a younger age of onset, functional impairments, and a higher rate of neurodevelopmental disorder and physical comorbidity compared to non-RC patients. OYE (19.4% frequency) was associated with a lower proportion of females, older age, higher occupational status, and lower rate of suicide ideation, psychotic symptoms, personality disorder, and alcohol or substance abuse. Mood stabilizers were prescribed in ≥80% of cases, while antipsychotics were prescribed in half of the cases (more in RC and less in OYE). Antidepressant prescription rates were lower in OYE than in RC. CONCLUSIONS: RC and OYE generally show opposing characteristics, but the details of the opposite parameters are distinctive. Clinicians can help predict the progression of BD by understanding the clinical background and characteristics of these opposing clinical features.
OBJECTIVE: Rapid cycling (RC) presents a risk of greater severity in bipolar disorder (BD), whereas patients with one-year euthymia (OYE) have better prognosis. The purpose of this study was to identify the clinical background and prescription characteristics of patients in the two opposing states of current RC and OYE from a large sample (N = 2609) in a multicenter treatment survey on BD in psychiatric clinics (MUSUBI). METHODS: MUSIBI was a cross-sectional study wherein questionnaires, based on a retrospective medical record survey of consecutive cases of BD, were distributed to 176 outpatient clinics. The questionnaire collected information on patient background, current episode, and clinical and prescription characteristics. OYE was defined as the presence of a euthymic state for at least 12 months. RESULTS: In this study, current RC (9.7% frequency) was significantly higher in females, had a younger age of onset, functional impairments, and a higher rate of neurodevelopmental disorder and physical comorbidity compared to non-RC patients. OYE (19.4% frequency) was associated with a lower proportion of females, older age, higher occupational status, and lower rate of suicide ideation, psychotic symptoms, personality disorder, and alcohol or substance abuse. Mood stabilizers were prescribed in ≥80% of cases, while antipsychotics were prescribed in half of the cases (more in RC and less in OYE). Antidepressant prescription rates were lower in OYE than in RC. CONCLUSIONS: RC and OYE generally show opposing characteristics, but the details of the opposite parameters are distinctive. Clinicians can help predict the progression of BD by understanding the clinical background and characteristics of these opposing clinical features.