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A re‐examination of antidepressant treatment‐emergent mania in bipolar disorders: evidence of gender differences
Author(s) -
Scott J.,
BrichantPetitjean C.,
Etain B.,
Henry C.,
Kahn J.P.,
Azorin J.M.,
Leboyer M.,
Bellivier F.
Publication year - 2017
Publication title -
acta psychiatrica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.849
H-Index - 146
eISSN - 1600-0447
pISSN - 0001-690X
DOI - 10.1111/acps.12728
Subject(s) - mania , antidepressant , psychiatry , bipolar disorder , major depressive episode , psychology , odds ratio , major depressive disorder , medicine , clinical psychology , mood , anxiety
Objective To explore the prevalence and clinical profile of males and females who develop antidepressant treatment‐emergent mania ( ATEM ). Method 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). Conclusion 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.