Skip to main content Accessibility help
×
Home

Clinical and prognostic implications of seasonal pattern in bipolar disorder: a 10-year follow-up of 302 patients

  • J. M. GOIKOLEA (a1), F. COLOM (a1) (a2), A. MARTÍNEZ-ARÁN (a1), J. SÁNCHEZ-MORENO (a1) (a3), A. GIORDANO (a1) (a4), A. BULBENA (a5) and E. VIETA (a1)...

Abstract

Background

More than 20% of bipolar patients may present with seasonal pattern (SP). Seasonality can alter the course of bipolar disorder. However, to date, long-term follow-up studies of bipolar patients presenting with SP are scarce. We present a 10-year follow-up study comparing clinical and demographic features of bipolar patients with and without SP.

Method

Three hundred and twenty-five bipolar I and II patients were followed up for at least 10 years. SP was defined according to DSM-IV criteria. Clinical variables were obtained from structured interviews with the patients and their relatives. Patients with and without SP were compared regarding clinical and sociodemographic variables and a stepwise logistic regression was performed.

Results

Seventy-seven patients (25·5%) were classified as presenting with SP, while 225 (74·5%) were considered as presenting with no significant seasonal variation. Twenty-three patients (7%) were excluded from the study because it was unclear whether they had seasonality or not. There were no differences between groups regarding demographic variables. Patients with SP predominantly presented with bipolar II disorder, depressive onset, and depressive predominant polarity. The greater burden of depression did not correlate with indirect indicators of severity, such as suicidality, hospitalizations or psychotic symptoms.

Conclusions

Our study links the presence of SP with both bipolar II disorder and predominant depressive component. However, we could not find any difference regarding functionality or hospitalization rates. Modifications in the criteria to define SP are suggested for a better understanding of bipolar disorder.

Copyright

Corresponding author

*Address for correspondence: Dr Eduard Vieta, Director Bipolar Disorders Program, Clinical Institute of Neuroscience, Hospital Clinic, University of Barcelona, Villarroel 170, 08036 Barcelona, Spain. (Email: evieta@clinic.ub.es)

References

Hide All
Arnold, L. M. (2003). Gender differences in bipolar disorder. Psychiatric Clinics of North America 26, 595620.
Cassidy, F. & Carroll, B. J. (2002). Seasonal variation of mixed and pure episodes of bipolar disorder. Journal of Affective Disorders 68, 2531.
Christensen, E. M., Larsen, J. K. & Gjerris, A. (2003). The stability of the Seasonal Pattern Assessment Questionnaire score index over time and the validity compared to classification according to DSM-III-R. Journal of Affective Disorders 74, 167172.
Colom, F., Vieta, E., Daban, C., Pacchiarotti, I. & Sanchez-Moreno, J. (2006). Clinical and therapeutic implications of predominant polarity in bipolar disorder. Journal of Affective Disorders 93, 1317.
Faedda, G. L., Tondo, L., Teicher, M. H., Baldessarini, R. J., Gelbard, H. A. & Floris, G. F. (1993). Seasonal mood disorders. Patterns of seasonal recurrence in mania and depression. Archives of General Psychiatry 50, 1723.
Friedman, E., Gyulai, L., Bhargava, M., Landen, M., Wisniewski, S., Foris, J., Ostacher, M., Medina, R. & Thase, M. (2006). Seasonal changes in clinical status in bipolar disorder: a prospective study in 1000 STEP-BD patients. Acta Psychiatrica Scandinavica 113, 510517.
Goikolea, J. M., Miralles, G., Bulbena Cabre, A., Vieta, E. & Bulbena, A. (2003). Spanish adaptation of the Seasonal Pattern Assessment Questionnaire (SPAQ) in the adult and children-adolescent versions. Actas Españolas de Psiquiatría 31, 192198.
Hakkarainen, R., Johansson, C., Kieseppa, T., Partonen, T., Koskenvuo, M., Kaprio, J. & Lonnqvist, J. (2003). Seasonal changes, sleep length and circadian preference among twins with bipolar disorder. BMC Psychiatry 3, 6.
Holmes, T. H. & Rahe, R. H. (1967). The Social Readjustment Rating Scale. Journal of Psychosomatic Research 11, 213218.
Jang, K. L., Lam, R. W., Livesley, W. J. & Vernon, P. A. (1997). Gender differences in the heritability of seasonal mood changes. Psychiatry Research 70, 145154.
Madden, P. A., Heath, A. C., Rosenthal, N. E. & Martin, N. G. (1996). Seasonal changes in mood and behaviour. The role of genetic factors. Archives of General Psychiatry 53, 4755.
Partonen, T. & Lonnqvist, J. (1996). Seasonal variation in bipolar disorder. British Journal of Psychiatry 169, 641646.
Sakamoto, K., Nakadaira, S., Kamo, K. & Takahashi, K. (1995). A longitudinal follow-up study of seasonal affective disorder. American Journal of Psychiatry 152, 862868.
Sayer, H. K., Marshall, S. & Mellsop, G. W. (1991). Mania and seasonality in the southern hemisphere. Journal of Affective Disorders 23, 151156.
Schaffer, A., Levitt, A. J. & Boyle, M. (2003). Influence of season and latitude in a community sample of subjects with bipolar disorder. Canadian Journal Psychiatry 48, 277280.
Shin, K., Schaffer, A., Levitt, A. J. & Boyle, M. H. (2005). Seasonality in a community sample of bipolar, unipolar and control subjects. Journal of Affective Disorders 86, 1925.
Silverstone, T., Romans, S., Hunt, N. & McPherson, H. (1995). Is there a seasonal pattern of relapse in bipolar affective disorders? A dual northern and southern hemisphere cohort study. British Journal of Psychiatry 167, 5860.

Metrics

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed