Rapid Cycling Bipolar Disorder Associated With Hospitalization and Female Gender

Bipolar disorder sign on a paper and glasses.
Researchers conducted a retrospective review to assess the clinical and demographic characteristics of patients with and without rapid cycling in bipolar disorder.

Hospitalization, prevalent polarity, and female gender were found to increase the risk for rapid cycling in bipolar disorder, according to a study published in European Psychiatry based on data from the National Epidemiological Research on Bipolar Disorder (RENDiBi) project in Italy.

Researchers retrospectively studied cross-sectional data of 1675 patients (961 female) with a diagnosis of bipolar disorder. Data were collected from multiple Italian psychiatry clinics from April 2014 to March 2015 with the aim of comparing clinical and demographic characteristics of patients with and without rapid cycling. Chi-squared, Student’s t-test, and multivariate logistic regression analyses looked at several variables, including gender, education, history of hospitalizations, and prevalent polarity.

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In the final multivariate regression analysis, the researchers found unidentifiable prevalent polarity (vs manic polarity: odds ratio [OR], 2.86; P =.01; vs depressive polarity: OR, 1.76; P =.02), hospitalization in the previous year (no vs yes: OR, 0.63; P =.02), and female gender (male vs female: OR, 0.64; P =.04) to be positively associated with rapid cycling in bipolar disorder.

“A higher frequency of [rapid cycling] in women than men is one of the most replicated findings across studies about this topic,” the investigators noted.

One key limitation of the research was the retrospective nature of the study, as well as the varying settings of care.

“Patients [with rapid cycling] require careful clinical monitoring to prevent recurrent hospitalization also in the light of a more frequently observed poor compliance,” the investigators concluded.


Buoli M, Cesana BM, Maina G, et al. Correlates of current rapid-cycling bipolar disorder: results from the Italian multicentric RENDiBi study. Eur Psychiatry. 2019;62:82-89.