Rapid cycling bipolar disorders in primary and tertiary care treated patients.

摘要: Rapid cycling (RC) is included in the DSM-IV as a course specifier of bipolar I disorder (BDI) or II (BDII). It affects 13–30% patients, depending on diagnostic criteria and inclusion BDII subjects (1–3). Since original introduction term by Dunner Fieve (4), studies have examined RC context demographic, clinical factors, illness course, response to treatment. The majority identified marker for risk recurrence, suicidal behavior, comorbidity, poor outcome, decreased functioning, relative treatment resistance not only lithium, but also valproate (5–8). In light these findings, importance continuing study phenomenology hope improving mental health, social burden, quality life patients clear. Most data pertaining been obtained research centers. Hence, they may be biased selection with particular characteristics their generalizability primary care population questionable. Although there no (BD) comparing versus secondary tertiary treated such are available major depression suggest marked differences between subjects. Depression less severe (9), present different subset depressive symptoms (10, 11), rates suicidality (11), preceding events (12), demographic including sex, age, comorbidity (9). fields medicine outside psychiatry, from setting has questioned (13). Despite fact that almost three-quarters some countries settings (14), remain least studied population. To best our knowledge, yet examining factors associated purely community-treated absence more specific data, findings centers possibly limited used. The principal aim this was characterize variables lifetime history BDI patients. care, we expected replicate settings, e.g., association BDII, female hypothyroidism, lithium valproate. We then compared at university-aflliated outpatient department, expecting find greater severity among subjects, manifesting higher proportion lower