Factors associated with the frequency of manic and depressive episodes in bipolar disorder: a multicenter study in China

Abstract Background Mania and depression are the predominant mood episodes in bipolar disorder (BD), and their frequency significantly affects the long-term prognosis of patients. Method This is a multicenter, longitudinal cohort study in China. Sociodemographic and clinical characteristics of patie...

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Main Authors: Shuang Liu, Jin-Jie Xu, Xue-Quan Zhu, Bing-Bing Fu, Yan-Li Pan, Cong-Cong Sun, Sheng Li, Gao-Ming Xie, Ling Zhang
Format: Article
Language:English
Published: BMC 2025-05-01
Series:BMC Psychiatry
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Online Access:https://doi.org/10.1186/s12888-025-06863-8
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author Shuang Liu
Jin-Jie Xu
Xue-Quan Zhu
Bing-Bing Fu
Yan-Li Pan
Cong-Cong Sun
Sheng Li
Gao-Ming Xie
Ling Zhang
author_facet Shuang Liu
Jin-Jie Xu
Xue-Quan Zhu
Bing-Bing Fu
Yan-Li Pan
Cong-Cong Sun
Sheng Li
Gao-Ming Xie
Ling Zhang
author_sort Shuang Liu
collection DOAJ
description Abstract Background Mania and depression are the predominant mood episodes in bipolar disorder (BD), and their frequency significantly affects the long-term prognosis of patients. Method This is a multicenter, longitudinal cohort study in China. Sociodemographic and clinical characteristics of patients were statistically analyzed. Poisson regression analyses were performed to identify factors associated with the frequency of manic and depressive episodes. Results A total of 520 BD patients were enrolled in this study. Poisson regression model analysis showed that shorter years of education (OR = 1.03, P = 0.03), mixed polarity of the first episode compared to mania (OR = 2.33, P < 0.01) or depression (OR = 1.79, P = 0.01), earlier age at diagnosis (OR = 1.03, P = 0.01), comorbid substance use disorder (OR = 1.41, P = 0.02), presence of psychotic symptoms (OR = 1.18, P = 0.04), use of antidepressant medication (OR = 1.52, P = 0.01), and non-use of mood stabilizers (OR = 1.57, P<0.01) are positively associated with the frequency of manic episodes. Being male (OR = 1.22, P = 0.01), the use of mood stabilizers (OR = 1.47, P<0.01) and a diagnosis of bipolar II disorder (BD-II) compared to bipolar I disorder (BD-I) (OR = 1.27, P = 0.01) are positively associated with the frequency of depressive episodes. Conclusion The study highlights the critical association of clinical and sociodemographic factors with the frequency of manic and depressive episodes in BD patients. Addressing these factors may improve long-term outcomes for individuals with bipolar disorder.
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issn 1471-244X
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spelling doaj-art-144e907bc7d449888102ba8ecbb4062c2025-08-20T01:53:25ZengBMCBMC Psychiatry1471-244X2025-05-012511910.1186/s12888-025-06863-8Factors associated with the frequency of manic and depressive episodes in bipolar disorder: a multicenter study in ChinaShuang Liu0Jin-Jie Xu1Xue-Quan Zhu2Bing-Bing Fu3Yan-Li Pan4Cong-Cong Sun5Sheng Li6Gao-Ming Xie7Ling Zhang8Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Capital Medical UniversityBeijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Capital Medical UniversityBeijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Capital Medical UniversityBeijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Capital Medical UniversityBeijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Capital Medical UniversityBeijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Capital Medical UniversityBeijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Capital Medical UniversityBeijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Capital Medical UniversityBeijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Capital Medical UniversityAbstract Background Mania and depression are the predominant mood episodes in bipolar disorder (BD), and their frequency significantly affects the long-term prognosis of patients. Method This is a multicenter, longitudinal cohort study in China. Sociodemographic and clinical characteristics of patients were statistically analyzed. Poisson regression analyses were performed to identify factors associated with the frequency of manic and depressive episodes. Results A total of 520 BD patients were enrolled in this study. Poisson regression model analysis showed that shorter years of education (OR = 1.03, P = 0.03), mixed polarity of the first episode compared to mania (OR = 2.33, P < 0.01) or depression (OR = 1.79, P = 0.01), earlier age at diagnosis (OR = 1.03, P = 0.01), comorbid substance use disorder (OR = 1.41, P = 0.02), presence of psychotic symptoms (OR = 1.18, P = 0.04), use of antidepressant medication (OR = 1.52, P = 0.01), and non-use of mood stabilizers (OR = 1.57, P<0.01) are positively associated with the frequency of manic episodes. Being male (OR = 1.22, P = 0.01), the use of mood stabilizers (OR = 1.47, P<0.01) and a diagnosis of bipolar II disorder (BD-II) compared to bipolar I disorder (BD-I) (OR = 1.27, P = 0.01) are positively associated with the frequency of depressive episodes. Conclusion The study highlights the critical association of clinical and sociodemographic factors with the frequency of manic and depressive episodes in BD patients. Addressing these factors may improve long-term outcomes for individuals with bipolar disorder.https://doi.org/10.1186/s12888-025-06863-8Bipolar disorderManic episodesDepressive episodesChinaMulticenter study
spellingShingle Shuang Liu
Jin-Jie Xu
Xue-Quan Zhu
Bing-Bing Fu
Yan-Li Pan
Cong-Cong Sun
Sheng Li
Gao-Ming Xie
Ling Zhang
Factors associated with the frequency of manic and depressive episodes in bipolar disorder: a multicenter study in China
BMC Psychiatry
Bipolar disorder
Manic episodes
Depressive episodes
China
Multicenter study
title Factors associated with the frequency of manic and depressive episodes in bipolar disorder: a multicenter study in China
title_full Factors associated with the frequency of manic and depressive episodes in bipolar disorder: a multicenter study in China
title_fullStr Factors associated with the frequency of manic and depressive episodes in bipolar disorder: a multicenter study in China
title_full_unstemmed Factors associated with the frequency of manic and depressive episodes in bipolar disorder: a multicenter study in China
title_short Factors associated with the frequency of manic and depressive episodes in bipolar disorder: a multicenter study in China
title_sort factors associated with the frequency of manic and depressive episodes in bipolar disorder a multicenter study in china
topic Bipolar disorder
Manic episodes
Depressive episodes
China
Multicenter study
url https://doi.org/10.1186/s12888-025-06863-8
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