{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,7]],"date-time":"2026-06-07T09:01:25Z","timestamp":1780822885641,"version":"3.54.1"},"reference-count":43,"publisher":"Elsevier BV","license":[{"start":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T00:00:00Z","timestamp":1769904000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T00:00:00Z","timestamp":1769904000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2025,10,25]],"date-time":"2025-10-25T00:00:00Z","timestamp":1761350400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100020595","name":"National Science and Technology Council","doi-asserted-by":"publisher","award":["111\\u20132314-B-182A-027-"],"award-info":[{"award-number":["111\\u20132314-B-182A-027-"]}],"id":[{"id":"10.13039\/100020595","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100020595","name":"National Science and Technology Council","doi-asserted-by":"publisher","award":["109\\u20132314-B-182A-009-MY2"],"award-info":[{"award-number":["109\\u20132314-B-182A-009-MY2"]}],"id":[{"id":"10.13039\/100020595","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100020595","name":"National Science and Technology Council","doi-asserted-by":"publisher","award":["112\\u20132314-B-182-070-MY3"],"award-info":[{"award-number":["112\\u20132314-B-182-070-MY3"]}],"id":[{"id":"10.13039\/100020595","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004606","name":"Chang Gung Medical Foundation","doi-asserted-by":"publisher","award":["CORPG8P0561"],"award-info":[{"award-number":["CORPG8P0561"]}],"id":[{"id":"10.13039\/501100004606","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004606","name":"Chang Gung Medical Foundation","doi-asserted-by":"publisher","award":["CMRPG8P0631"],"award-info":[{"award-number":["CMRPG8P0631"]}],"id":[{"id":"10.13039\/501100004606","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004606","name":"Chang Gung Medical Foundation","doi-asserted-by":"publisher","award":["BMRPJ30"],"award-info":[{"award-number":["BMRPJ30"]}],"id":[{"id":"10.13039\/501100004606","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Journal of Affective Disorders"],"published-print":{"date-parts":[[2026,2]]},"DOI":"10.1016\/j.jad.2025.120518","type":"journal-article","created":{"date-parts":[[2025,10,23]],"date-time":"2025-10-23T23:58:33Z","timestamp":1761263913000},"page":"120518","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":2,"special_numbering":"PA","title":["Uncovering predictors of bipolar II conversion to bipolar I: A machine learning analysis of national health records in Taiwan"],"prefix":"10.1016","volume":"394","author":[{"given":"Chih-Wei","family":"Hsu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yang-Chieh Brian","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liang-Jen","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kuo-Chuan","family":"Hung","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mu-Hong","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eduard","family":"Vieta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chien-Yuan","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1138-5586","authenticated-orcid":false,"given":"Chih-Sung","family":"Liang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andre F.","family":"Carvalho","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.jad.2025.120518_bb0005","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1037\/a0023973","article-title":"Progression along the bipolar spectrum: a longitudinal study of predictors of conversion from bipolar spectrum conditions to bipolar I and II disorders","volume":"121","author":"Alloy","year":"2012","journal-title":"J. Abnorm. Psychol."},{"key":"10.1016\/j.jad.2025.120518_bb0010","doi-asserted-by":"crossref","first-page":"708","DOI":"10.1176\/appi.ajp.2009.09010105","article-title":"Gender and depressive symptoms in 711 patients with bipolar disorder evaluated prospectively in the Stanley Foundation bipolar treatment outcome network","volume":"167","author":"Altshuler","year":"2010","journal-title":"Am. J. Psychiatry"},{"key":"10.1016\/j.jad.2025.120518_bb0015","doi-asserted-by":"crossref","first-page":"1130","DOI":"10.1176\/ajp.152.8.1130","article-title":"Antidepressant-induced mania and cycle acceleration: a controversy revisited","volume":"152","author":"Altshuler","year":"1995","journal-title":"Am. J. Psychiatry"},{"key":"10.1016\/j.jad.2025.120518_bb0020","doi-asserted-by":"crossref","first-page":"313","DOI":"10.1176\/appi.ajp.163.2.313","article-title":"Lower switch rate in depressed patients with bipolar II than bipolar I disorder treated adjunctively with second-generation antidepressants","volume":"163","author":"Altshuler","year":"2006","journal-title":"Am. J. Psychiatry"},{"key":"10.1016\/j.jad.2025.120518_bb0025","doi-asserted-by":"crossref","DOI":"10.1200\/JCO.24.00117","article-title":"Machine learning to predict mortality in older patients with cancer: development and external validation of the geriatric cancer scoring system using two large French cohorts","author":"Audureau","year":"2025","journal-title":"J. Clin. Oncol."},{"key":"10.1016\/j.jad.2025.120518_bb0030","doi-asserted-by":"crossref","first-page":"1001","DOI":"10.1016\/j.jaac.2011.07.005","article-title":"Course of subthreshold bipolar disorder in youth: diagnostic progression from bipolar disorder not otherwise specified","volume":"50","author":"Axelson","year":"2011","journal-title":"J. Am. Acad. Child Adolesc. Psychiatry"},{"key":"10.1016\/j.jad.2025.120518_bb0035","doi-asserted-by":"crossref","first-page":"795","DOI":"10.1176\/appi.ajp.2009.08101569","article-title":"Four-year longitudinal course of children and adolescents with bipolar spectrum disorders: the course and outcome of bipolar youth (COBY) study","volume":"166","author":"Birmaher","year":"2009","journal-title":"Am. J. Psychiatry"},{"key":"10.1016\/j.jad.2025.120518_bb0040","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0106871","article-title":"Predictors of the onset of manic symptoms and a (hypo)manic episode in patients with major depressive disorder","volume":"9","author":"Boschloo","year":"2014","journal-title":"PLoS One"},{"key":"10.1016\/j.jad.2025.120518_bb0045","doi-asserted-by":"crossref","first-page":"360","DOI":"10.1111\/acps.12358","article-title":"Brain-derived neurotrophic factor and inflammatory markers in school-aged children with early trauma","volume":"131","author":"B\u00fccker","year":"2015","journal-title":"Acta Psychiatr. Scand."},{"key":"10.1016\/j.jad.2025.120518_bb0050","doi-asserted-by":"crossref","first-page":"252","DOI":"10.1192\/bjp.138.3.252","article-title":"Lithium induces rapid relief of depression in tricyclic antidepressant drug non-responders","volume":"138","author":"C","year":"1981","journal-title":"Br. J. Psychiatry"},{"key":"10.1016\/j.jad.2025.120518_bb0055","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1056\/NEJMra1906193","article-title":"Bipolar Disorder","volume":"383","author":"Carvalho","year":"2020","journal-title":"N. Engl. J. Med."},{"key":"10.1016\/j.jad.2025.120518_bb0060","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1159\/000535777","article-title":"Mortality and Lithium-protective effects after first-episode mania diagnosis in bipolar disorder: a Nationwide retrospective cohort study in Taiwan","volume":"93","author":"Carvalho","year":"2024","journal-title":"Psychother. Psychosom."},{"key":"10.1016\/j.jad.2025.120518_bb0065","doi-asserted-by":"crossref","first-page":"1335","DOI":"10.5498\/wjp.v12.i12.1335","article-title":"Bipolar disorder in the international classification of diseases-eleventh version: a review of the changes, their basis, and usefulness","volume":"12","author":"Chakrabarti","year":"2022","journal-title":"World J Psychiatry."},{"key":"10.1016\/j.jad.2025.120518_bb0070","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1016\/j.euroneuro.2024.03.014","article-title":"Pre-existing chronic physical morbidity and excess mortality in people with bipolar disorder: a population-based cohort study in 2008-2018","volume":"84","author":"Chan","year":"2024","journal-title":"Eur. Neuropsychopharmacol."},{"key":"10.1016\/j.jad.2025.120518_bb0075","series-title":"Xgboost: a scalable tree boosting system, proceedings of the 22nd acm sigkdd international conference on knowledge discovery and data mining","first-page":"785","author":"Chen","year":"2016"},{"key":"10.1016\/j.jad.2025.120518_bb0080","article-title":"Predicting new-onset post-stroke depression from real-world data using machine learning algorithm","volume":"14","author":"Chen","year":"2023","journal-title":"Front. Psychol."},{"key":"10.1016\/j.jad.2025.120518_bb0085","doi-asserted-by":"crossref","first-page":"663","DOI":"10.1001\/jamapsychiatry.2024.0378","article-title":"Susceptibility to treatment-resistant depression within families","volume":"81","author":"Cheng","year":"2024","journal-title":"JAMA Psychiatry"},{"key":"10.1016\/j.jad.2025.120518_bb0090","first-page":"507","article-title":"Optimal structure identification with greedy search","volume":"3","author":"Chickering","year":"2002","journal-title":"J. Mach. Learn. Res."},{"key":"10.1016\/j.jad.2025.120518_bb0095","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1176\/ajp.152.3.385","article-title":"Long-term stability of polarity distinctions in the affective disorders","volume":"152","author":"Coryell","year":"1995","journal-title":"Am. J. Psychiatry"},{"key":"10.1016\/j.jad.2025.120518_bb0100","doi-asserted-by":"crossref","first-page":"1647","DOI":"10.1038\/npp.2012.10","article-title":"Selective DNA methylation of BDNF promoter in bipolar disorder: differences among patients with BDI and BDII","volume":"37","author":"D'Addario","year":"2012","journal-title":"Neuropsychopharmacology"},{"key":"10.1016\/j.jad.2025.120518_bb0105","doi-asserted-by":"crossref","first-page":"863","DOI":"10.1001\/jamapsychiatry.2024.1133","article-title":"Adolescent and adult transitions from major depressive disorder to bipolar disorder","volume":"81","author":"Desai Bostrom","year":"2024","journal-title":"JAMA Psychiatry"},{"key":"10.1016\/j.jad.2025.120518_bb0110","doi-asserted-by":"crossref","first-page":"437","DOI":"10.3109\/09540261.2010.514601","article-title":"Is sex important? Gender differences in bipolar disorder","volume":"22","author":"Diflorio","year":"2010","journal-title":"Int. Rev. Psychiatry"},{"key":"10.1016\/j.jad.2025.120518_bb0115","doi-asserted-by":"crossref","first-page":"112","DOI":"10.1016\/j.jad.2012.06.014","article-title":"Diagnostic conversions from major depressive disorder into bipolar disorder in an outpatient setting: results of a retrospective chart review","volume":"144","author":"Dudek","year":"2013","journal-title":"J. Affect. Disord."},{"issue":"Suppl. 1","key":"10.1016\/j.jad.2025.120518_bb0120","first-page":"S160","article-title":"Are there different genotypes in bipolar II and bipolar I disorder and if so, why then do we tend to observe unipolar depression converting to bipolar II and then converting to bipolar I?","volume":"27","author":"Fawcett","year":"2015","journal-title":"Psychiatr. Danub."},{"key":"10.1016\/j.jad.2025.120518_bb0125","doi-asserted-by":"crossref","first-page":"829","DOI":"10.4088\/JCP.11m06912","article-title":"Risks for the transition from major depressive disorder to bipolar disorder in the National Epidemiologic Survey on alcohol and related conditions","volume":"73","author":"Gilman","year":"2012","journal-title":"J. Clin. Psychiatry"},{"key":"10.1016\/j.jad.2025.120518_bb0130","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1016\/j.jad.2023.11.047","article-title":"Valproic acid monitoring: serum prediction using a machine learning framework from multicenter real-world data","volume":"347","author":"Hsu","year":"2024","journal-title":"J. Affect. Disord."},{"key":"10.1016\/j.jad.2025.120518_bb0135","doi-asserted-by":"crossref","DOI":"10.3390\/biomedicines9111558","article-title":"Predicting serum levels of Lithium-treated patients: a supervised machine learning approach","volume":"9","author":"Hsu","year":"2021","journal-title":"Biomedicines"},{"key":"10.1016\/j.jad.2025.120518_bb0140","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1111\/acps.13313","article-title":"Month of birth and mental disorders: a population-based study and validation using global meta-analysis","volume":"144","author":"Hsu","year":"2021","journal-title":"Acta Psychiatr. Scand."},{"key":"10.1016\/j.jad.2025.120518_bb0145","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1016\/j.euroneuro.2023.04.018","article-title":"Disease progression to bipolar disorder among adolescents and young adults with antidepressant-resistant and antidepressant-responsive depression: does antidepressant class matter?","volume":"74","author":"Hsu","year":"2023","journal-title":"Eur. Neuropsychopharmacol."},{"key":"10.1016\/j.jad.2025.120518_bb0150","doi-asserted-by":"crossref","first-page":"2054","DOI":"10.1200\/JCO.22.01189","article-title":"Risk of major psychiatric disorders among children and adolescents surviving malignancies: a Nationwide longitudinal study","volume":"41","author":"Hsu","year":"2023","journal-title":"J. Clin. Oncol."},{"key":"10.1016\/j.jad.2025.120518_bb0155","first-page":"8","article-title":"XGBoost, a machine learning method, predicts neurological recovery in patients with cervical spinal cord injury","volume":"1","author":"Inoue","year":"2020","journal-title":"Neurotrauma Rep."},{"key":"10.1016\/j.jad.2025.120518_bb0160","series-title":"A Unified Approach to Interpreting Model Predictions, Proceedings of the 31st International Conference on Neural Information Processing Systems","first-page":"4768","author":"Lundberg","year":"2017"},{"key":"10.1016\/j.jad.2025.120518_bb0165","doi-asserted-by":"crossref","first-page":"642","DOI":"10.1038\/s41398-021-01760-6","article-title":"Predictors of diagnostic transition from major depressive disorder to bipolar disorder: a retrospective observational network study","volume":"11","author":"Nestsiarovich","year":"2021","journal-title":"Transl. Psychiatry"},{"key":"10.1016\/j.jad.2025.120518_bb0170","doi-asserted-by":"crossref","first-page":"1370","DOI":"10.1001\/jama.2023.18588","article-title":"Diagnosis and treatment of bipolar disorder: a review","volume":"330","author":"Nierenberg","year":"2023","journal-title":"Jama"},{"key":"10.1016\/j.jad.2025.120518_bb0175","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1016\/S0165-0327(01)00309-3","article-title":"Anxiety disorders comorbidity in bipolar I, bipolar II and unipolar major depression: results from a population-based study in Hungary","volume":"67","author":"Rihmer","year":"2001","journal-title":"J. Affect. Disord."},{"key":"10.1016\/j.jad.2025.120518_bb0180","doi-asserted-by":"crossref","first-page":"775","DOI":"10.1111\/j.1469-7610.2011.02519.x","article-title":"Cognitive dysfunction is worse among pediatric patients with bipolar disorder type I than type II","volume":"53","author":"Schenkel","year":"2012","journal-title":"J. Child Psychol. Psychiatry"},{"key":"10.1016\/j.jad.2025.120518_bb0185","doi-asserted-by":"crossref","DOI":"10.1016\/j.ajp.2021.102935","article-title":"Differences in prescription patterns between real-world outpatients with bipolar I and II disorders in the MUSUBI survey","volume":"67","author":"Shinozaki","year":"2022","journal-title":"Asian J. Psychiatr."},{"key":"10.1016\/j.jad.2025.120518_bb0190","doi-asserted-by":"crossref","DOI":"10.1016\/j.mex.2023.102119","article-title":"An optimized XGBoost-based machine learning method for predicting wave run-up on a sloping beach","volume":"10","author":"Tarwidi","year":"2023","journal-title":"MethodsX"},{"key":"10.1016\/j.jad.2025.120518_bb0195","doi-asserted-by":"crossref","first-page":"126","DOI":"10.1111\/acps.13721","article-title":"Antidepressant-associated diagnostic change from major depressive to bipolar disorder","volume":"150","author":"Tondo","year":"2024","journal-title":"Acta Psychiatr. Scand."},{"key":"10.1016\/j.jad.2025.120518_bb0200","doi-asserted-by":"crossref","first-page":"1067","DOI":"10.1176\/appi.ajp.2014.13111501","article-title":"The risk of switch to mania in patients with bipolar disorder during treatment with an antidepressant alone and in combination with a mood stabilizer","volume":"171","author":"Viktorin","year":"2014","journal-title":"Am. J. Psychiatry"},{"key":"10.1016\/j.jad.2025.120518_bb0205","doi-asserted-by":"crossref","first-page":"894","DOI":"10.1001\/jama.2023.24844","article-title":"What is bipolar disorder?","volume":"331","author":"Voelker","year":"2024","journal-title":"Jama"},{"key":"10.1016\/j.jad.2025.120518_bb0210","doi-asserted-by":"crossref","first-page":"430","DOI":"10.1056\/NEJMoa2300184","article-title":"Duration of adjunctive antidepressant maintenance in bipolar I depression","volume":"389","author":"Yatham","year":"2023","journal-title":"N. Engl. J. Med."},{"key":"10.1016\/j.jad.2025.120518_bb0215","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1111\/bdi.12609","article-title":"Canadian network for mood and anxiety treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) 2018 guidelines for the management of patients with bipolar disorder","volume":"20","author":"Yatham","year":"2018","journal-title":"Bipolar Disord."}],"container-title":["Journal of Affective Disorders"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0165032725019603?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0165032725019603?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,6,7]],"date-time":"2026-06-07T08:51:16Z","timestamp":1780822276000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S0165032725019603"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2]]},"references-count":43,"alternative-id":["S0165032725019603"],"URL":"https:\/\/doi.org\/10.1016\/j.jad.2025.120518","relation":{},"ISSN":["0165-0327"],"issn-type":[{"value":"0165-0327","type":"print"}],"subject":[],"published":{"date-parts":[[2026,2]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Uncovering predictors of bipolar II conversion to bipolar I: A machine learning analysis of national health records in Taiwan","name":"articletitle","label":"Article Title"},{"value":"Journal of Affective Disorders","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.jad.2025.120518","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2025 The Authors. Published by Elsevier B.V.","name":"copyright","label":"Copyright"}],"article-number":"120518"}}