{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T20:57:30Z","timestamp":1792789050807,"version":"4.5.0"},"reference-count":57,"publisher":"Cambridge University Press (CUP)","issue":"9","license":[{"start":{"date-parts":[[2022,3,24]],"date-time":"2022-03-24T00:00:00Z","timestamp":1648080000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100006477","name":"National Taiwan University","doi-asserted-by":"publisher","award":["109L7860"],"award-info":[{"award-number":["109L7860"]}],"id":[{"id":"10.13039\/501100006477","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Psychol. Med."],"published-print":{"date-parts":[[2023,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec id=\"S0033291722000782_sec_a1\"><jats:title>Backgrounds<\/jats:title><jats:p>A proportion of patients with bipolar disorder (BD) manifests with only unipolar mania (UM). This study examined relevant clinical features and psychosocial characteristics in UM compared with depressive-manic (D-M) subgroups. Moreover, comorbidity patterns of physical conditions and psychiatric disorders were evaluated between the UM and D-M groups.<\/jats:p><\/jats:sec><jats:sec id=\"S0033291722000782_sec_a2\" sec-type=\"methods\"><jats:title>Methods<\/jats:title><jats:p>This clinical retrospective study (<jats:italic>N<\/jats:italic> = 1015) analyzed cases with an average of 10 years of illness duration and a nationwide population-based cohort (<jats:italic>N<\/jats:italic> = 8343) followed up for 10 years in the Taiwanese population. UM was defined as patients who did not experience depressive episodes and were not prescribed adequate antidepressant treatment during the disease course of BD. Logistic regression models adjusted for relevant covariates were used to evaluate the characteristics and lifetime comorbidities in the two groups.<\/jats:p><\/jats:sec><jats:sec id=\"S0033291722000782_sec_a3\" sec-type=\"results\"><jats:title>Results<\/jats:title><jats:p>The proportion of UM ranged from 12.91% to 14.87% in the two datasets. Compared with the D-M group, the UM group had more psychotic symptoms, fewer suicidal behaviors, a higher proportion of morningness chronotype, better sleep quality, higher extraversion, lower neuroticism, and less harm avoidance personality traits. Substantially different lifetime comorbidity patterns were observed between the two groups.<\/jats:p><\/jats:sec><jats:sec id=\"S0033291722000782_sec_a4\" sec-type=\"conclusions\"><jats:title>Conclusions<\/jats:title><jats:p>Patients with UM exhibited distinct clinical and psychosocial features compared with patients with the D-M subtype. In particular, a higher risk of comorbid cardiovascular diseases and anxiety disorders is apparent in patients with D-M. Further studies are warranted to investigate the underlying mechanisms for diverse presentations in subgroups of BDs.<\/jats:p><\/jats:sec>","DOI":"10.1017\/s0033291722000782","type":"journal-article","created":{"date-parts":[[2022,3,25]],"date-time":"2022-03-25T03:51:30Z","timestamp":1648180290000},"page":"4103-4113","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":11,"title":["Characterization of clinical features and comorbidities between bipolar affective disorder with and without depressive 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Department of Public Health and Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Room 521, No. 17, Xuzhou Road, Taipei 10055, Taiwan, 2022. Published by Cambridge University Press","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http:\/\/creativecommons.org\/licenses\/by\/4.0\/), which permits unrestricted re- use, distribution and reproduction, provided the original article is properly cited.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}]}}