Department of Psychiatry, Seoul National University Bundang Hospital, Kyueonggi, Republic of Korea.
Department of Statistics, Seoul National University, Seoul, Republic of Korea.
Psychiatry Res. 2015 Feb 28;225(3):540-4. doi: 10.1016/j.psychres.2014.11.051. Epub 2014 Dec 6.
Seasonality is one of the key features in subjects with mood disorders and is involved in the multi-faceted nature of the clinical course. However, few studies have explored the clinical implications of seasonality in bipolar disorders. We examined the differential effects of seasonality on clinical variables between bipolar I and II disorder (BD I and II). Seasonality was assessed using the Seasonal Pattern Assessment Questionnaire (SPAQ) in 204 subjects with BD I and 308 with BD II. Following the comparisons between BD I and II groups, clinical characteristics related to seasonality were explored. Next, to predict the presence of seasonality, a logistic regression model was applied. The global seasonality score on the SPAQ was significantly higher in the BD II group than in the BD I group. In the BD I group, seasonality was associated with suicide attempt history. In the BD II group, on the other hand, seasonality was associated with female gender, depressive predominance, and premenstrual dysphoric disorder (PMDD). In the regression models, the presence of PMDD and female gender was significantly associated with seasonality in the BD II group. Our findings suggest that high seasonality tendency, a vulnerability maker for cyclic worsening, may contribute to a differential pattern of clinical characteristics in BD II.
季节性是心境障碍患者的一个主要特征，涉及到临床病程的多方面性质。然而，很少有研究探讨双相情感障碍季节性的临床意义。我们检查了季节性对双相 I 型和 II 型障碍（BD I 和 II）临床变量的差异影响。使用季节性模式评估问卷（SPAQ）评估了 204 名 BD I 患者和 308 名 BD II 患者的季节性。在比较 BD I 和 II 组之后，探讨了与季节性相关的临床特征。接下来，应用逻辑回归模型预测季节性的存在。BD II 组的 SPAQ 整体季节性评分明显高于 BD I 组。在 BD I 组中，季节性与自杀企图史有关。另一方面，在 BD II 组中，季节性与女性性别、抑郁优势和经前烦躁障碍（PMDD）有关。在回归模型中，PMDD 和女性性别在 BD II 组中与季节性显著相关。我们的研究结果表明，高季节性倾向，即周期性恶化的脆弱性因素，可能导致 BD II 临床特征的差异模式。
