{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T09:22:06Z","timestamp":1778750526771,"version":"3.51.4"},"reference-count":42,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2015,9,3]],"date-time":"2015-09-03T00:00:00Z","timestamp":1441238400000},"content-version":"vor","delay-in-days":2,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100015138","name":"Marriott Foundation","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100015138","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100000124","name":"Office of Women's Health Research","doi-asserted-by":"crossref","award":["K12HD065987"],"award-info":[{"award-number":["K12HD065987"]}],"id":[{"id":"10.13039\/100000124","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Bipolar Disorders"],"published-print":{"date-parts":[[2015,9]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>To examine the independent effects of sex on the risk of rapid cycling and other indicators of adverse illness course in patients with bipolar I disorder (<jats:styled-content style=\"fixed-case\">BP<\/jats:styled-content>\u2010I) or bipolar <jats:styled-content style=\"fixed-case\">II<\/jats:styled-content> disorder (<jats:styled-content style=\"fixed-case\">BP<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">II<\/jats:styled-content>).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We analyzed data from the first 1,225 patients enrolled in the Mayo Clinic Individualized Medicine Biobank for Bipolar Disorder. Demographic and clinical variables were ascertained using standardized questionnaires; height and weight were assessed to determine body mass index (<jats:styled-content style=\"fixed-case\">BMI<\/jats:styled-content>). Rates of rapid cycling, cycle acceleration, and increased severity of mood episodes over time were compared between women and men overall and within subgroups defined by bipolar disorder subtype (<jats:styled-content style=\"fixed-case\">BP<\/jats:styled-content>\u2010I or <jats:styled-content style=\"fixed-case\">BP<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">II<\/jats:styled-content>). Multiple logistic regression analysis was used to assess the independent effect of sex on the risk of these indicators of adverse illness course.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Women had significantly higher rates of rapid cycling than men. Overall rates of rapid cycling were higher in patients with <jats:styled-content style=\"fixed-case\">BP<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">II<\/jats:styled-content> than <jats:styled-content style=\"fixed-case\">BP<\/jats:styled-content>\u2010I; and sex differences in the rate of rapid cycling were more pronounced in patients with <jats:styled-content style=\"fixed-case\">BP<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">II<\/jats:styled-content> than <jats:styled-content style=\"fixed-case\">BP<\/jats:styled-content>\u2010I, although the power to detect statistically significant differences was reduced due to the lower sample size of subjects with <jats:styled-content style=\"fixed-case\">BP<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">II<\/jats:styled-content>. Female sex was a significant predictor of rapid cycling, cycle acceleration, and increased severity of mood episodes over time after adjusting for age, bipolar disorder subtype, <jats:styled-content style=\"fixed-case\">BMI<\/jats:styled-content>, having any comorbid psychiatric disorder, and current antidepressant use.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Female sex was associated with significantly higher risk of rapid cycling, cycle acceleration, and increased severity of mood episodes over time in a sample of 1,225 patients with bipolar disorders.<\/jats:p><\/jats:sec>","DOI":"10.1111\/bdi.12329","type":"journal-article","created":{"date-parts":[[2015,9,4]],"date-time":"2015-09-04T15:37:12Z","timestamp":1441381032000},"page":"670-676","source":"Crossref","is-referenced-by-count":44,"title":["Sex differences in the risk of rapid cycling and other indicators of adverse illness course in patients with bipolar I and II disorder"],"prefix":"10.1111","volume":"17","author":[{"given":"Almila","family":"Erol","sequence":"first","affiliation":[{"name":"Department of Psychiatry and Psychology Mayo Clinic Rochester MN USA"},{"name":"Department of Psychiatry Ataturk Education and Research Hospital Izmir Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stacey J","family":"Winham","sequence":"additional","affiliation":[{"name":"Division of Biomedical Statistics and Informatics Mayo Clinic Rochester MN USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susan L","family":"McElroy","sequence":"additional","affiliation":[{"name":"Lindner Center of HOPE Mason OH USA"},{"name":"University of Cincinnati Cincinnati OH USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark A","family":"Frye","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Psychology Mayo Clinic Rochester MN USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5578-4605","authenticated-orcid":false,"given":"Miguel L","family":"Prieto","sequence":"additional","affiliation":[{"name":"Departamento de Psiquiatr\u00eda Facultad de Medicina Universidad de los Andes Santiago Chile"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alfredo B","family":"Cuellar\u2010Barboza","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Universidad Autonoma de Nuevo Leon Monterrey Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Manuel","family":"Fuentes","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Universite Desarrollo and Clinica Allemana Santiago Chile"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer","family":"Geske","sequence":"additional","affiliation":[{"name":"Division of Biomedical Statistics and Informatics Mayo Clinic Rochester MN 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