{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T02:44:49Z","timestamp":1787021089088,"version":"build-2736575974"},"reference-count":75,"publisher":"Royal College of Psychiatrists","issue":"3","license":[{"start":{"date-parts":[[2024,5,6]],"date-time":"2024-05-06T00:00:00Z","timestamp":1714953600000},"content-version":"unspecified","delay-in-days":5,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["BJPsych open"],"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:sec id=\"S2056472424000516_sec_a1\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Identification of the predominant polarity, i.e. hypomanic\/manic (mPP) or depressive predominant polarity (dPP), might help clinicians to improve personalised management of bipolar disorder.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S2056472424000516_sec_a2\">\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>We performed a systematic review and meta-analysis to estimate prevalence and correlates of mPP and dPP in bipolar disorder.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S2056472424000516_sec_a3\" sec-type=\"methods\">\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>\n                      The protocol was registered in the Open Science Framework Registries (\n                      <jats:uri xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"https:\/\/doi.org\/10.17605\/OSF.IO\/8S2HU\">https:\/\/doi.org\/10.17605\/OSF.IO\/8S2HU<\/jats:uri>\n                      ). We searched main electronic databases up to December 2023 and performed random-effects meta-analyses of weighted prevalence of mPP and dPP. Odds ratios and weighted mean differences (WMDs) were used for relevant correlates.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S2056472424000516_sec_a4\" sec-type=\"results\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      We included 28 studies, providing information on rates and\/or correlates of mPP and dPP. We estimated similar rates of mPP (weighted prevalence = 30.0%, 95% CI: 23.1 to 37.4%) and dPP (weighted prevalence = 28.5%, 95% CI: 23.7 to 33.7%) in bipolar disorder. Younger age (WMD = \u22123.19, 95% CI: \u22125.30 to \u22121.08 years), male gender (odds ratio = 1.39, 95% CI: 1.10 to 1.76), bipolar-I disorder (odds ratio = 4.82, 95% CI: 2.27 to 10.24), psychotic features (odds ratio = 1.56, 95% CI: 1.01 to 2.41), earlier onset (WMD = \u22121.57, 95% CI: \u22122.88 to \u22120.26 years) and manic onset (odds ratio = 13.54, 95% CI: 5.83 to 31.46) were associated with mPP (\n                      <jats:italic>P<\/jats:italic>\n                      &lt; 0.05). Depressive onset (odds ratio = 12.09, 95% CI: 6.38 to 22.90), number of mood episodes (WMD = 0.99, 95% CI: 0.28 to 1.70 episodes), history of suicide attempts (odds ratio = 2.09, 95% CI: 1.49 to 2.93) and being in a relationship (odds ratio = 1.98, 95% CI: 1.22 to 3.22) were associated with dPP (\n                      <jats:italic>P<\/jats:italic>\n                      &lt; 0.05). No differences were estimated for other variables.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S2056472424000516_sec_a5\" sec-type=\"conclusions\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Despite some limitations, our findings support the hypothesis that predominant polarity might be a useful specifier of bipolar disorder. Evidence quality was mixed, considering effects magnitude, consistency, precision and publication bias. Different predominant polarities may identify subgroups of patients with specific clinical characteristics.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1192\/bjo.2024.51","type":"journal-article","created":{"date-parts":[[2024,5,6]],"date-time":"2024-05-06T04:30:02Z","timestamp":1714969802000},"update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":22,"title":["Prevalence and correlates of manic\/hypomanic and depressive predominant polarity in bipolar disorder: systematic review and 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