@article{ref1,
title="Risk factors for rapid cycling in bipolar disorder",
journal="Bipolar disorders",
year="2015",
author="Valentí, Marc and Pacchiarotti, Isabella and Undurraga, Juan and Bonnín, C. del Mar and Popovic, Dina and Goikolea, José M. and Torrent, Carla and Hidalgo-Mazzei, Diego and Colom, Francesc and Vieta, Eduard",
volume="17",
number="5",
pages="549-559",
abstract="OBJECTIVES: The aim of this study was to investigate the clinical factors associated with the development of rapid cycling, as well as to elucidate the role of antidepressants. <br><br>METHODS: The present study (NCT01503489) is a prospective, naturalistic cohort study conducted in a sample of 289 patients diagnosed with bipolar disorder followed and treated for up to 14 years. The patients were divided into two groups on the basis of the development of a rapid cycling course (n = 48) or no development of such a course (n = 241), and compared regarding sociodemographic, clinical, and outcome variables. <br><br>RESULTS: Among the 289 patients, 48 (16.6%) developed a rapid cycling course during the follow-up. Several differences were found between the two groups, but after performing Cox regression analysis, only atypical depressive symptoms (p = 0.001), age at onset (p = 0.015), and number of suicide attempts (p = 0.030) persisted as significantly associated with the development of a rapid cycling course. <br><br>CONCLUSIONS: The development of rapid cycling during the course of bipolar disorder is associated with a tendency to chronicity, with a poorer outcome, and with atypical depressive symptomatology. Our study also suggests that the development of rapid cycling is associated with a higher use of antidepressants.<p /> <p>Language: en</p>",
language="en",
issn="1398-5647",
doi="10.1111/bdi.12288",
url="http://dx.doi.org/10.1111/bdi.12288"
}