A bipolar II cohort (ABC): The association of functional disability with gender and rapid cycling

A re‐examination of antidepressant treatment‐emergent mania in bipolar disorders: evidence of gender differences

“…This finding reinforces the notion that the harmful effects of ADM can undermine their benefits if prescribing does not follow clinical practice guidelines. Second, our findings indicate that an ATEM may be the first indication that someone with depression is at risk of developing BD , and previous publications suggest that this risk is probably higher in BD I than II and in individuals aged less than 30 years . We can now add that the risk of ATEM in individuals with depressive onset polarity was significant in females, but not in males.…”

“…For example, some earlier studies were interpreted as indicating that ADM could induce BD or a ‘BD‐like syndrome’ in individuals who were ‘true’ unipolar cases . However, this notion, has largely been dispelled and it is mostly accepted that ADM may unmask an underlying BD, but not cause BD to develop in someone who has no prior risk . For instance, Bond and colleagues demonstrated that ATEM were identified in 14% of BD I, 7% of BD II, but only 1.5% of unipolar cases.…”

“…However, this notion, has largely been dispelled and it is mostly accepted that ADM may unmask an underlying BD, but not cause BD to develop in someone who has no prior risk . For instance, Bond and colleagues demonstrated that ATEM were identified in 14% of BD I, 7% of BD II, but only 1.5% of unipolar cases. Furthermore, rates of ‘unmasking’ of BD are particularly high in younger as compared to older individuals treated with ADM (age < 30 years: number needed to harm = 10) , so it is also relevant to suggest that clinicians give additional consideration to the risk to benefit ratios of all possible treatment approaches for depression (including therapies) in such populations.…”

“… to examined the occurrence of ATEM in a large, clinically representative sample of BD out‐patients. to employ strict definitions of ATEM status (see Rousseva et al, ) to minimise the inclusion of false‐positive cases and false‐negative controls, the study. as factors associated with ATEM status in previous publications are known to show different distributions in males and females (e.g. gender distributions of BD I compared to BD II; ASUD comorbidities) , we decided a priori to explore the combination of factors that best classified ATEM+ cases and ATEM‐ controls according to gender. …”

Rapid Cycling bei bipolar-affektiven Störungen: Klinik, Ätiologie und Behandlungsempfehlungen

“…Deutlicher ist die Befundlage hinsichtlich des klinischen Verlaufs und des Therapieoutcomes: Patienten mit Rapid Cycling weisen eine insgesamt höhere Episodenzahl und häufigere Hospitalisierung auf [22,30], einen schlechteren Langzeitverlauf [34,55] und reduziertes Therapieansprechen [30,47], eine höhere Rate an Komorbiditäten sowie eine stärkere Einschränkung des Funktionsniveaus [24,56] im Vergleich zu Patienten mit einer bipolaren Störung ohne Rapid Cycling. Hinsichtlich des langfristigen Behandlungsverlaufs konnten Koukopoulus und Kollegen zeigen, dass 40 % der Patienten mit Rapid Cycling einen Verlauf mit weiteren und immer schweren Episoden zeigen [6].…”