Rapid cycling bipolar affective disorder: diagnosis and management - a brief review

Author/s
Madhavan Seshadri, Daniel Davies
Citation
Issue 3 Summer 2013
CEPiP.2013;1:188-191
Abstract

Bipolar affective disorders are highly prevalent in the general population. The course of bipolar affective disorder is characterised by episodes of mania or hypomania, and periods of depression. One clear-cut manic episode is enough for the diagnosis of bipolar disorder (according to DSM IV criteria) but many patients have two or more episodes. When a patient has 4 or more pathological mood episodes in one year, the course is defined as ‘rapid cycling’. It is important to identify rapid cycling in clinical practice as these patients do not respond as well to conventional treatment. Outcomes can be improved by a combination of management of risk factors for rapid cycling and the use of appropriate pharmacological intervention. This article focuses on the diagnostic criteria, clinical features, risk factors and management of rapid cycling bipolar disorder.

Keywords: bipolar disorder, rapid cycling, risk factors, treatment

Cite as: Cutting Edge Psychiatry in Practice 2013, 3(1):188-191; https://doi.org/10.65031/yedy2635

References

  1. Regeer EJ, Ten Have M, Rosso ML, Hakkaart van Roijen L, Vollebergh W, Nolen WA. Prevalence of bipolar disorder in the general population: a Reappraisal Study of the Netherlands Mental Health Survey and Incidence Study. Acta Psychiatrica Scandinavica 2004;110 (5):374-382. https://doi.org/10.1111/j.1600-0447.2004.00363.x
  2. ten Have M, Vollebergh W, Bijl R, Nolen WA. Bipolar disorder in the general population in The Netherlands (prevalence, consequences and care utilisation): results from The Netherlands Mental Health Survey and Incidence Study (NEMESIS). Journal of affective disorders 2002;68 (2):203-213. https://doi.org/10.1016/s0165-0327(00)00310-4
  3. Szadoczky E, Papp ZS, Vitrai J, Rıhmer Z, Füredi J. The prevalence of major depressive and bipolar disorders in Hungary: results from a national epidemiologic survey. Journal of affective disorders 1998;50 (2):153-162. https://doi.org/10.1016/s0165-0327(98)00056-1
  4. Faravelli C, Degl’Innocenti BG, Aiazzi L, Incerpi G, Pallanti S Carlo Faravelli, Benedetta Guerrini Degl’Innocenti, Leandro Aiazzi, Guya Incerpi, Stefano Pallanti. Journal of Affective Disorders 1990;20 (2):135-141. https://doi.org/10.1016/0165-0327(90)90127-t
  5. Pini S, de Queiroz V, Pagnin D, Pezawas L, Angst J, Cassano GB, Wittchen HU. Prevalence and burden of bipolar disorders in European countries. European Neuropsychopharmacology 2005;15 (4):425- 434. https://doi.org/10.1016/j.euroneuro.2005.04.011
  6. Diagnostic and statistical manual of mental disorders: DSM-IV-TR. American Psychiatric Association. American Psychiatric Publishing Inc; 2000. https://doi.org/10.1176/appi.books.9780890423349
  7. Clinical Factors in Lithium Carbonate Prophylaxis Failure David L. Dunner, MD; Ronald R. Fieve, MD Arch Gen Psychiatry 1974;30 (2):229-233. https://doi.org/10.1001/archpsyc.1974.01760080077013
  8. World Health Organization The ICD-10 classification of mental and behavioural disorders: clinical descriptions and diagnostic guidelines. World Health Organization; 1992. https://doi.org/10.1177/146642409311300216
  9. Kramlinger KG, Post RM. Ultra-rapid and ultradian cycling in bipolar affective illness. The British Journal of Psychiatry 1996;168 (3):314-323. https://doi.org/10.1192/bjp.168.3.314
  10. Lee S et al. Rapid-cycling bipolar disorder: cross-national community study: BJP 2010:196:217-225.  
  11. Post RM, Rubinow DR, Ballenger JC. Conditioning and sensitisation in the longitudinal course of affective illness. The British Journal of Psychiatry 1986;149 (2):191-201. https://doi.org/10.1192/bjp.149.2.191
  12. Schneck CD. Treatment of rapid-cycling bipolar disorder. The Journal of clinical psychiatry 2006;67:22.               
  13. Bipolar disorder: The management of bipolar disorder in adults, children and adolescents, in primary and secondary care.NICE Guidance 2006;CG38.
  14. Schneck CD et al. The Prospective Course of Rapid-Cycling Bipolar Disorder: Findings From the STEP-BD: American Journal of Psychiatry 2008; 165:370–377. https://doi.org/10.1176/appi.ajp.2007.05081484