We were not able to determine whether the symptom of irritability/aggression recorded in the studies in this review included only episodic phenomena or encompassed more chronic presentations.
This is in contrast to the mean duration for other studies which point to more chronic presentations; Azar et al. had a mean of 37.5 days [ 2], while Rathore et al. had a series with the shortest symptom duration being 2 weeks [ 20].
On the other hand, a more chronic symptom presentation would tend to give a lower frequency, as described by Wang N et al. [ 9].
Although Hartmann and colleagues [ 8] reported an overall effect size of 1.2 in weight gain for inpatient treatments, the overall lack of research on inpatient programs is a critical gap given that those with lower BMIs and more severe, chronic presentations, are more representative of inpatient treatment.
Diagnosis of bipolar disorder (BPD) in preschool children is controversial, although preliminary data suggest that children with BPD may present with classic manic symptoms in a more chronic, rapid cycling presentation.
Pyogenic flexor tenosynovitis usually is caused by penetrating trauma to the finger, although patients who are immunocompromised may have a more indolent and chronic presentation, and a history of trauma in these patients may be remote or absent.
A number of studies have linked psychotic features to more chronic and severe presentations of bipolar disorder [ 33].
This may reflect a higher representation of MPO-pANCA in the Chinese cohort, as MPO-pANCA patients have been shown in earlier studies to present with more chronic lesions at the time of presentation compared to PR3-cANCA positive patients [ 25].
For this study chronic presentation of PTSD has been defined as being exposed to two or more traumatic events, the presence of comorbid mental health difficulties and evidence of functional impairment.
