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Characterization of rapid cycling bipolar patients presenting with major depressive episode within the BRIDGE‐II‐MIX study
Author(s) -
Antonietta Furio Maria,
Popovic Dina,
Vieta Eduard,
Stukalin Yelena,
Hagin Michal,
Torrent Carla,
Azorin JeanMichel,
Angst Jules,
Bowden Charles L.,
Mosolov Sergey,
Young Allan H.,
Perugi Giulio
Publication year - 2021
Publication title -
bipolar disorders
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.285
H-Index - 129
eISSN - 1399-5618
pISSN - 1398-5647
DOI - 10.1111/bdi.12994
Subject(s) - bipolar disorder , irritability , depression (economics) , impulsivity , psychiatry , psychomotor agitation , anxiety , psychology , major depressive episode , mood , bipolar ii disorder , medicine , clinical psychology , economics , macroeconomics
Objectives The “Bipolar Disorders: Improving Diagnosis, Guidance, and Education” (BRIDGE‐II‐Mix) study aimed to estimate the frequency of mixed states in patients with a major depressive episode (MDE) according to different definitions and to compare their clinical validity, looking into specific features such as rapid cycling (RC). Methods Psychiatric symptoms, socio‐demographic, and clinical variables were collected from a sample of 2811 MDE patients, of which 726 (25.8%) were diagnosed with bipolar disorder (BD). The characteristics of bipolar patients with RC (BD‐RC) and without (BD‐NRC) RC were compared. Results Of 726 BD patients, 159 (21.9%) met DSM‐5 criteria for RC. BD‐RC group presented a higher number of lifetime depressive episodes ( p < 0.001) with shorter duration of depressive episodes, and more psychiatric comorbidities, as well as higher rates of atypical features ( p = 0.016) and concomitant (hypo)manic symptoms (irritable mood ( p = 0.001); risky behavior ( p = 0.005); impulsivity ( p = 0.006); and psychomotor agitation ( p = 0.029)). Patients with RC had a worse functioning ( p = 0.033), more obesity ( p = 0.003), and were significantly more likely to be treated with three or more drugs ( p = 0.007). Conclusions Important clinical differences between bipolar patients with and without a RC include more depressive morbidity, higher incidence of anxiety disorders, addiction, bulimia, and borderline personality disorder, as well as atypical features during depression and symptoms such as irritability, risky behavior, impulsivity, and agitation. RC patients had poorer functioning than patients without RC, more obesity, and had to be treated with more drugs.