Journal
REVISTA BRASILEIRA DE PSIQUIATRIA
Volume 38, Issue 4, Pages 270-274Publisher
ASSOC BRASILEIRA PSIQUIATRIA
DOI: 10.1590/1516-4446-2015-1789
Keywords
Bipolar disorder; age of onset; suicide; antidepressants
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Funding
- Instituto Nacional de Ciencia e Tecnologia - Medicina Translacional (INCT-TM)
- Conselho Nacional de Desenvolvimento Cientifico e Tecnologico (CNPq)
- Coordenacao de Aperfeicoamento de Pessoal de Nivel Superior (CAPES)
- Centro de Estudos de Transtornos de Humor e Ansiedade (CETHA)
- Fundacao de Amparo e Pesquisa do Estado de Sao Paulo (FAPESP)
- CNPq
- CAPES
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Objective: 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. Methods: 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. Results: 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. Conclusion: The presence of RC in the previous year was associated with specific clinical characteristics closely related to worse outcome in the course of BD.
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