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A re-examination of antidepressant treatment-emergent mania in bipolar disorders: evidence of gender differences

Lookup NU author(s): Emeritus Professor Jan Scott


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© 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd Objective: To explore the prevalence and clinical profile of males and females who develop antidepressant treatment-emergent mania (ATEM). Method: From an original sample of 754 patients with BD, we identified ATEM+ cases (n = 75) and ATEM- controls (n = 135) that met stringent criteria. We specifically examined the combinations of clinical factors that best classified males and females as ATEM+ cases. Results: Seventy-five individuals were classified as ATEM+; 87% of ATEM events occurred during antidepressant monotherapy. Regression analyses demonstrated that the presence of an alcohol and/or substance use disorder [Odds Ratio (OR) 6.37], a history of one or more suicide attempts (OR 4.19) and higher number of depressive episodes per year of illness (OR 1.71) correctly classified 73% of males. In contrast, 84% of females were correctly classified on the basis of a positive history of thyroid disorder (OR 3.23), a positive family history of BD I (OR 2.68) and depressive onset polarity (OR 2.01). Conclusion: Using stringent definitions of ATEM status to reduce the probability of inclusion of false-positive cases and false-negative controls, we identified for the first time that the risk profiles for the development of an ATEM differ significantly according to gender.

Publication metadata

Author(s): Scott J, Brichant-Petitjean C, Etain B, Henry C, Kahn J-P, Azorin J-M, Leboyer M, Bellivier F

Publication type: Article

Publication status: Published

Journal: Acta Psychiatrica Scandinavica

Year: 2017

Volume: 135

Issue: 5

Pages: 479-488

Print publication date: 01/05/2017

Online publication date: 01/04/2017

Acceptance date: 06/03/2017

ISSN (print): 0001-690X

ISSN (electronic): 1600-0447

Publisher: Blackwell Publishing Ltd


DOI: 10.1111/acps.12728


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