Bipolar disorder with seasonal pattern: clinical characteristics and gender influences.

Pierre Alexis Geoffroy (1, 2, 3, 4) , Frank Bellivier (1, 3, 5) , Jan Scott (3, 6) , Carole Boudebesse (1, 2, 3) , Mohamed Lajnef (1, 3) , Sébastien Gard (3, 7) , Jean-Pierre Kahn (3, 8) , Jean-Michel Azorin (3, 9) , Chantal Henry (1, 2, 3) , Marion Leboyer (1, 2, 3) , Bruno Etain (1, 2, 3)

1 IMRB - Institut Mondor de Recherche Biomédicale
2 Service de psychiatrie
3 Fondation FondaMental [Créteil]
4 Pôle de psychiatrie
5 Pôle Neurosciences
6 Academic Psychiatry
7 Service de psychiatrie adulte
8 Service de Psychiatrie et Psychologie Clinique
9 Pôle de Psychiatrie

Bipolar disorder (BD) has a multifactorial etiology with heterogeneous clinical presentations. Around 25% of BD patients may present with a depressive seasonal pattern (SP). However, there are limited scientific data on the prevalence of SP, its clinical manifestations, and any gender influence. Four hundred and fifty-two BD I and II cases (62% female), recruited from three French university-affiliated psychiatric departments, were assessed for SP. Clinical, treatment, and sociodemographic variables were obtained from structured interviews. One hundred and two (23%) cases met DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition) criteria for SP, with similar frequency according to gender. Multivariate analysis showed a significant association between SP and BD II (odds ratio [OR] = 1.99, p = 0.01), lifetime history of rapid cycling (OR = 2.05, p = 0.02), eating disorders (OR = 2.94, p = 0.003), and total number of depressive episodes (OR = 1.13, p = 0.002). Seventy-one percent of cases were correctly classified by this analysis. However, when stratifying the analyses by gender, SP was associated with BD II subtype (OR = 2.89, p = 0.017) and total number of depressive episodes (OR = 1.21, p = 0.0018) in males but with rapid cycling (OR = 3.02, p = 0.0027) and eating disorders (OR = 2.60, p = 0.016) in females. This is the first study to identify different associations between SP and clinical characteristics of BD according to gender. The authors suggest that SP represents a potentially important specifier of BD. These findings indicate that seasonality may reflect increased severity or complexity of disorder.

Mots clés: bipolar disorder; seasonality; season; gender; rapid cycling; eating disorder

Domaines: Psychiatrie et santé mentale

Pierre Alexis Geoffroy, Frank Bellivier, Jan Scott, Carole Boudebesse, Mohamed Lajnef, et al.. Bipolar disorder with seasonal pattern: clinical characteristics and gender influences.: Bipolar patients with seasonal pattern. Chronobiology International, 2013, 30 (9), pp.1101-7. ⟨10.3109/07420528.2013.800091⟩. ⟨inserm-00851213⟩