O038 - Clinical and Prognostic Relevance of Cycle Pattern Recognition in BipolarDisorder: A Further Step Toward Personalised Treatment Pathways?
O038
Clinical and Prognostic Relevance of Cycle Pattern Recognition in Bipolar
Disorder: A Further Step Toward Personalised Treatment Pathways?
A. E. Koukopoulos 1,*, D. Janiri 2, M. Pinto 2, G. Serra 3, L. De Chiara 4, A. M. D’Onofrio 2, G. Camardese 1, G. Sani 2
1Department of Life Science, Health, and Health Professions,, Link Campus University, 2Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, 3Child and Adolescent Neuropsychiatry Unit, Bambino Gesù Children's Hospital, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), 4Psychiatry, Struttura Residenziale Psichiatrica Samadi S.p.A., Rome, Italy
Introduction: Introduction
Bipolar disorder (BD) presents with heterogeneous longitudinal cycling patterns: manic-depressive (MD), depressive-manic (DM), and irregular (IRR). Although cycle type has long been considered a central feature, studies systematically examining its impact on clinical course remain limited.
Objectives: To investigate associations between cycle type (MD, DM, IRR) and clinical-demographic features in a large, well-characterised sample of BD-I and BD-II patients, with focus on onset polarity, hospitalisations, suicidality, seasonality, predominant polarity, and diagnostic subtype.
Methods: A total of 378 outpatients with DSM-5 BD-I/BD-II were assessed using life charts to classify cycle type. Clinical and demographic variables were collected via structured interviews and records. Group differences were tested with chi-square and ANOVA/Kruskal–Wallis; multivariate logistic regressions assessed independent associations.
Results: Among 378 patients, 140 (37.0%) showed MD, 92 (24.3%) DM, and 146 (38.6%) IRR cycles. MD patients were more likely to present manic/hypomanic onset, manic predominant polarity, BD-I diagnosis, and higher hospitalisation rates. DM cycles strongly associated with depressive onset and depressive predominant polarity. Both MD and DM showed higher seasonality than IRR. BD-II was more frequent in DM and IRR. Suicidal ideation did not differ; suicide attempts were more frequent in IRR.
Table 1. Key clinical characteristics by cycle type
Variable |
MD (n=140) |
DM (n=92) |
IRR (n=146) |
|
Manic onset % |
52.9 |
4.3 |
14.4 |
|
Depressive onset % |
17.8 |
92.4 |
65.7 |
|
Hospitalisation % |
42.1 |
42.4 |
26.7 |
|
Seasonality % |
32.9 |
36.9 |
4.8 |
Table 2. Predominant polarity distribution
Predominant Polarity |
MD % |
DM % |
IRR % |
|
Manic |
32.1 |
4.3 |
14.4 |
|
Depressive |
9.3 |
39.1 |
33.6 |
|
Undetermined |
58.6 |
56.5 |
52.0 |
Table 3. Diagnostic subtype
Diagnosis |
MD % |
DM % |
IRR % |
|
BD-I |
80.0 |
40.2 |
41.8 |
|
BD-II |
20.0 |
59.8 |
58.2 |
Conclusions: Cycle type represents a clinically meaningful longitudinal specifier in BD. Early recognition may inform prognosis and guide personalised preventive and therapeutic interventions. Systematic adoption of cycle pattern classification could enhance precision psychiatry in bipolar disorder.
Disclosure of Interest: None Declared