What is it about?

Bipolar disorder (BD) is a chronic illness characterized by recurrent acute episodes of low mood and energy ("depression"), alternating with episodes of euphoria and excessive energy ("mania-hypomania") that affects 2% of people worldwide. BD entails a high personal cost, for their individuals and for society at multiple levels. Some people with BD have a tendency to manifest "depressive" or "manic" episodes during specific moments of the year; this tendency is called "seasonal pattern" and it is present in up to 15% of people with BD. Patients with a seasonal pattern might have a different course of BD compared to other patients. In our study, we aimed to explore the clinical characteristics of patients with BD and a seasonal pattern, compared to patients with BD without a seasonal pattern. We recruited 708 patients (503 with BD type I and 205 with BD type II), and 117 (16.5%) had a seasonal pattern. Our results outline a novel positive association of seasonal pattern with a tendency to manifest mood episodes of both polarities (i.e., depressive and manic) during the course of the illness, BD type II, a family history of mood disorder, and with fewer aggressiveness-related symptoms. Also, patients with seasonal pattern showed a course of BD with a biphasic pattern, with a tendency to show yearly manic episodes during spring-summer, and depressive episodes during autumn-winter.

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Why is it important?

This is the first study exploring the presence and the clinical correlates of seasonal pattern in a large sample of people with BD.


An early assessment of a seasonal pattern may help in predicting the course of BD and the time of emerging episodes but may be particularly difficult to tackle from a therapeutic point of view. Hence, patients with a seasonal pattern may have more predictable episodes, but also be more difficult to treat.

Giovanna Fico
Hospital Clinic de Barcelona

Read the Original

This page is a summary of: Clinical correlates of seasonality in bipolar disorder: A specifier that needs specification?, Acta Psychiatrica Scandinavica, December 2020, Wiley,
DOI: 10.1111/acps.13251.
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