“…In general, RCBD has been associated with worse disease outcome 9,10 and more severe disability. 7,11,12 More specifically, many factors have been described to be associated with RC, such as female gender, 5,13 earlier age at onset, 6,12 increased risk for suicide, 13,14 predominance of depression, 15,16 hypothyroidism, 6,17 bipolar type II disorder, 8,18,19 and higher rates of antidepressants use. 7,20 However, some of these associations are still controversial, and many studies have been criticized regarding aspects such as lack of a uniform definition of RC and use of heterogeneous samples.…”