Objective Seasonal pattern (SP) is a bipolar disorder (BD) specifier that indicates a tendency towards affective relapses during specific moments of the year. SP affects 15%–25% of BD patients. In the past, SP was applied only to depressive relapses while, in DSM‐5, SP may be applied to both depressive and (hypo)manic episodes. We examined the association between different clinical correlates of BD and SP according to its current definition in a cohort of patients with BD type I (BDI) and II (BDII). Methods Patients were recruited from a specialized unit and assessed according to the season of relapse and type of episode per season. SP and non‐SP patients were compared looking into sociodemographic and clinical correlates. Significant variables at univariate comparisons were included in multivariate logistic regression with SP as the dependent variable. Results 708 patients were enrolled (503 BDI, 205 BDII), and 117 (16.5%) fulfilled DSM‐5 criteria for SP. The mean age was 45.3 years (SD = 14.18), and 389 were female (54.9%). The logistic regression model included a significant contribution of BDII (OR = 2.23, CI 1.4–3.55), family history of mood disorder (OR = 1.97, CI 1.29–3.01), undetermined predominant polarity (OR = 0.44, CI 0.28–0.70), and aggressive behavior (OR = 0.42, CI 0.23–0.75). Conclusion Our results outline a novel positive association of SP with undetermined predominant polarity, BDII, family history of mood disorder, and with fewer aggressiveness‐related symptoms. Seasonality is associated with a biphasic pattern with similar dominance of (hypo)mania and depression and is more frequent in BDII as compared to BDI. Seasonal episodes may be easier to predict, but difficult to prevent.

IntroductionPrenatal risk factors, such as gestational complications and exposure to stress during pregnancy, may have a role in the development of many psychiatric disorders including eating disorders.AimTo investigate the impact of prenatal stress exposure on the development and clinical features of anorexia nervosa.MethodsOne hundred and nine patients with a lifetime diagnosis of anorexia nervosa and 118 healthy controls underwent a clinical assessment, which included interviews, questionnaires and a neuropsychological battery. The mothers of the patients and controls underwent a specific interview focused on stressful life events, which occurred during pregnancy. Obstetric and neonatal records were consulted.ResultsThe mothers of patients experienced more severe stressful episodes during pregnancy than the mothers of controls and the perceived distress showed significant positive correlation with both total number of obstetrical complications and placental weight. In patients, the severity of stressful events was strongly associated to cognitive rigidity and perseverance.ConclusionsPrenatal stress exposure might be a risk factor for the development of anorexia nervosa and it is associated with cognitive traits of rigidity and perseverance.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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