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At 1-year the cumulative incidence difference was ~ 0.4%, and at 5-years was ~ 0.7%

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These discoveries have given rise to the idea that bipolar disorder is a bioenergetic and metabolic disease with psychiatric manifestations, and that disruptions in the molecular and cellular signalling networks that regulate brain energy metabolism in a biphasic manner are a primary, sufficient cause of bipolar disorder-related phenomena [189]