Clinical and biochemical correlates of rapid cycling in bipolar disorder: A 20-year inpatient study

IF 1.5 4区医学 Q2 PSYCHIATRY

European Journal of Psychiatry Pub Date : 2026-04-01 Epub Date: 2026-04-30 DOI:10.1016/j.ejpsy.2026.100355

Anna Pan , Enrico Capuzzi , Francesca Legnani , Luigi Piccirilli , Martina Di Paolo , Alessandro Ceresa , Cecilia Maria Esposito , Luisa Cirella , Teresa Surace , Ilaria Tagliabue , Massimo Clerici , Massimiliano Buoli

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引用次数: 0

Abstract

Background and objectives

Rapid cycling (RC) is a severe course specifier of bipolar disorder (BD), associated with worse clinical outcomes and increased treatment complexity. The objective of this study is to identify differences in clinical and biochemical parameters between bipolar patients with or without rapid cycling (RC).

Methods

A total of 468 inpatients were included in the present study. Demographic, clinical and biochemical data, related to the first day of hospitalization, were obtained through a screening of the clinical charts and intranet hospital applications. The two groups identified by the lifetime presence of RC were compared by t tests for continuous variables and χ² tests for qualitative ones; logistic regression models were subsequently performed.

Results

Logistic regressions showed that patients with versus without RC: were more frequently hospitalized for a depressive episode (p < 0.01), had more previous psychiatric hospitalizations (p < 0.01), presented more often multiple medical comorbidity (p = 0.05) and seasonality (p = 0.02) as well as lower Global Assessment of Functioning (GAF) scores at the time of hospitalization (p = 0.02).

RC patients also exhibited lower creatine phosphokinase (CPK) (p < 0.01) and neutrophil levels (p < 0.01).

Conclusions

The presence of RC is important in designing a personalized treatment of bipolar patients as it is associated with (1) clinical variables of greater severity, (2) the tendency to a depressive profile and (3) multiple medical comorbidities. Further multi-center studies are needed to confirm the results of the present study in a framework of precision psychiatry.

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双相情感障碍快速循环的临床和生化相关性：一项20年住院患者研究

背景和目的快速循环（RC）是双相情感障碍（BD）的一个严重病程指标，与较差的临床结果和增加的治疗复杂性相关。本研究的目的是确定有或没有快速循环（RC）的双相患者的临床和生化参数的差异。方法本研究共纳入468例住院患者。通过筛选临床图表和intranet医院应用程序，获得了与住院第一天有关的人口统计学、临床和生化数据。用连续变量进行t检验，定性变量进行χ2检验；随后进行了逻辑回归模型。结果logistic回归分析显示，与非RC患者相比，RC患者因抑郁发作而住院的频率更高（p < 0.01），既往精神科住院的频率更高（p < 0.01），出现多种医学共病的频率更高（p = 0.05），季节性（p = 0.02），以及住院时整体功能评估（GAF）得分更低（p = 0.02）。RC患者也表现出较低的肌酸磷酸激酶（CPK）（p < 0.01）和中性粒细胞水平（p < 0.01）。结论：RC的存在对于设计双相情感障碍患者的个性化治疗非常重要，因为它与(1)更严重的临床变量，(2)抑郁倾向和(3)多种医学合并症有关。进一步的多中心研究需要在精确精神病学的框架内证实本研究的结果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

European Journal of Psychiatry PSYCHIATRY-

CiteScore

2.90

自引率

0.00%

发文量

审稿时长

43 days

期刊介绍： The European journal of psychiatry is a quarterly publication founded in 1986 and directed by Professor Seva until his death in 2004. It was originally intended to report “the scientific activity of European psychiatrists” and “to bring about a greater degree of communication” among them. However, “since scientific knowledge has no geographical or cultural boundaries, is open to contributions from all over the world”. These principles are maintained in the new stage of the journal, now expanded with the help of an American editor.