Bipolar Disorder Quiz

Check your symptoms and
find possible causes with AI for free

Worried about your symptoms?

Start the Bipolar Disorder test with our free AI Symptom Checker.

This will help us personalize your assessment.

Shiba

By starting the symptom checker, you agree to the Privacy Policy and Terms of Use

Lack of motivation

Insomnia

Compulsive liar

Mood swings

Impulsive behavior

Emotional rollercoaster

Manic episodes

Sleeping too much

Malaise

Feeling hopeless

Feeling sad for no reason

Depressive episodes

Not seeing your symptoms? No worries!

What is Bipolar Disorder?

A disorder marked by extreme and persistent shifts in mood that last for weeks to months, from periods of sustained depression to periods of elevated mood and euphoria. The precise cause is unclear, but genetic and environmental factors contribute.

Typical Symptoms of Bipolar Disorder

Diagnostic Questions for Bipolar Disorder

Your doctor may ask these questions to check for this disease:

  • Have you been feeling unusually energetic lately?
  • Do you frequently think about harming or killing yourself?
  • Do you feel stressed or unhappy about going to work or school?
  • Have you been experiencing decreased motivation recently?
  • Do you have difficulty concentrating?

Treatment of Bipolar Disorder

Consistent medication and therapy are important and effective. In severe cases, hospitalization may be necessary to prevent the patient from harming themselves or others during their extreme mood episodes.

Reviewed By:

Weston S. Ferrer, MD

Weston S. Ferrer, MD (Psychiatry)

Weston Ferrer is a physician leader, psychiatrist, and clinical informaticist based in San Francisco. With nearly a decade of experience in academia and more recent immersion in industry, he has made significant contributions to the fields of digital health, health tech, and healthcare innovation. | As an Associate Professor at UCSF, Weston was involved in teaching, leadership, and clinical practice, focusing on the intersection of technology and mental health. He recently led mental health clinical for Verily (formerly Google Life Sciences), where he applied his expertise to develop innovative solutions for mental healthcare using the tools of AI/ML, digital therapeutics, clinical analytics, and more.. | Weston is known for his unique ability to innovate and support product development while bringing pragmatism to technology entrepreneurship. He is a strong advocate for patient-centered care and is committed to leveraging technology to improve the health and well-being of individuals and communities. |

Yu Shirai, MD

Yu Shirai, MD (Psychiatry)

Dr. Shirai works at the Yotsuya Yui Clinic for mental health treatment for English and Portuguese-speaking patients. He treats a wide range of patients from neurodevelopmental disorders to dementia in children and participates in knowledge sharing through the Diversity Clinic.

From our team of 50+ doctors

Content updated on Jan 14, 2025

Following the Medical Content Editorial Policy

Was this page helpful?

Tell your friends about us.

We would love to help them too.

smily Shiba-inu looking

Think you might have
Bipolar Disorder?

Try a symptom check test

How Ubie Can Help You

With a free 3-min Bipolar Disorder quiz, powered by Ubie's AI and doctors, find possible causes of your symptoms.

This questionnaire is customized to your situation and symptoms, including the following personal information:

  • Biological Sex - helps us provide relevant suggestions for male vs. female conditions.

  • Age - adjusts our guidance based on any age-related health factors.

  • History - considers past illnesses, surgeries, family history, and lifestyle choices.

Your symptoms

Input your symptoms

Our AI

Our AI checks your symptoms

Your report

You get your personalized report

Your personal report will tell you

✔  When to see a doctor

✔︎  What causes your symptoms

✔︎  Treatment information etc.

People with similar symptoms also use Ubie's symptom checker to find possible causes

See full list

Symptoms Related to Bipolar Disorder

Diseases Related to Bipolar Disorder

FAQs

Q.

Exhausted yet Racing? Recognizing Mixed State Symptoms: New Medical Next Steps

A.

Feeling physically drained yet mentally wired can signal a bipolar mixed state, where depressive and manic or hypomanic symptoms happen together and increase the risk of impulsive behavior and suicidal thoughts. There are several factors to consider. See below to understand more, including how to track symptoms, use a screening tool, and talk with a clinician about mood stabilizers, atypical antipsychotics, therapy, sleep and substance habits, and when to seek urgent help.

References:

* Ghaemi SN, Bauer M, Pacchiarotti I, et al. Mixed features in Bipolar Disorder and Unipolar Depression: Epidemiology, Diagnosis and Treatment. World J Biol Psychiatry. 2016 Feb;17(1):1-10. doi: 10.3109/15622975.2015.1090333. Epub 2015 Oct 13. PMID: 26462791.

* Parker G, Paterson A, Brotchie H, et al. The recognition and management of mixed states in unipolar depression. J Affect Disord. 2017 Jan 1;207:1-6. doi: 10.1016/j.jad.2016.08.057. Epub 2016 Sep 3. PMID: 27600889.

* Vieta E, Suppes T, Eggensperger S, et al. Mixed features as defined by DSM-5: prevalence and clinical implications. J Affect Disord. 2018 Jan 1;225:615-620. doi: 10.1016/j.jad.2017.08.083. Epub 2017 Sep 1. PMID: 28917208.

* Perugi G, Fornaro M. Mixed Features: A New Diagnostic Dimension in DSM-5. J Clin Psychiatry. 2018;79(5):18ad12242. doi: 10.4088/JCP.18ad12242. PMID: 30462704.

* Fountoulakis KN, Gonda X, Vieta E. Mixed depression: a distinct entity. Psychopathology. 2021;54(1):1-12. doi: 10.1159/000511854. Epub 2021 Jan 12. PMID: 33433947.

See more on Doctor's Note

Q.

Living with a Bipolar Partner? Why Treatment Fails & New Clinical Steps

A.

There are several factors to consider: treatment often fails due to misdiagnosis, stopping or underusing mood stabilizers, relying on medication without therapy, sleep disruption, substance use, and high stress. Modern care emphasizes accurate diagnosis, mood stabilizers such as lithium, structured routines and sleep with IPSRT, early warning sign monitoring with a relapse plan, family focused therapy, and active suicide risk assessment. See the complete guidance below for specific partner actions like protecting sleep, encouraging care without power struggles, setting financial safeguards, and knowing when to seek urgent help, since these details can shape your next medical and relationship steps.

References:

* Marazziti D, Consoli G, Ciapparelli A, et al. Poor adherence to medication in bipolar disorder: why the partner's support is not enough. Compr Psychiatry. 2016 Mar;66:96-102. doi: 10.1016/j.comppsych.2015.12.008. Epub 2015 Dec 17. PMID: 26978438; PMCID: PMC4780516.

* van der Putten-Veldman MH, Mulder J, Dries R, et al. The impact of the couple relationship on treatment adherence and outcome in bipolar disorder: a systematic review. Bipolar Disord. 2020 Jul;22(5):451-460. doi: 10.1111/bdi.12879. Epub 2020 Mar 27. PMID: 32622728.

* Tse L, Tang B, Lai F, et al. Factors affecting treatment adherence in bipolar disorder: The role of family environment. PLoS One. 2017 Feb 28;12(2):e0172111. doi: 10.1371/journal.pone.0172111. PMID: 28243306; PMCID: PMC5330368.

* Dimitropoulos G, Hettema JM, Goldstein TR, et al. Couple-based interventions for bipolar disorder: a systematic review. Bipolar Disord. 2017 Aug;19(5):341-353. doi: 10.1111/bdi.12507. Epub 2017 Apr 6. PMID: 28389146; PMCID: PMC5529124.

* Parikh SV, Zaretsky A, Dhanoa T, et al. Psychoeducational programs for caregivers of patients with bipolar disorder: a systematic review. Bipolar Disord. 2016 Feb;18(1):3-12. doi: 10.1111/bdi.12351. Epub 2015 Nov 12. PMID: 26563606.

See more on Doctor's Note

Q.

Meds Failing? Why Genetic Testing for Bipolar Medication Is Your Vital Next Step

A.

If your bipolar meds keep failing, pharmacogenetic testing may be your vital next step by revealing how your genes metabolize mood stabilizers, antipsychotics, and antidepressants, which can reduce trial and error and side effects, though it does not diagnose or guarantee a response. There are several factors to consider, including who should get tested, which medicines have the strongest evidence, test quality and insurance, how doctors use the results, and urgent symptoms that need immediate care; see below to understand more.

References:

* Kim DD, Chen A, Lerer B. Pharmacogenomics of Bipolar Disorder: A Comprehensive Review. Pharmacogenomics. 2018 Nov;19(15):1179-1191. doi: 10.2217/pgs-2018-0097. Epub 2018 Oct 31. PMID: 30375369.

* Rybakowski JK. Pharmacogenomics of Lithium Treatment in Bipolar Disorder. Pharmaceuticals (Basel). 2020 Feb 28;13(3):39. doi: 10.3390/ph13030039. PMID: 32121307; PMCID: PMC7151040.

* Reif A, Rösler B, Fritzen S, Kittel-Schneider S. Pharmacogenomic Testing in Psychiatry: A Guide to Drug-Gene Interactions and Clinical Implementation. Front Pharmacol. 2021 Mar 19;12:649131. doi: 10.3389/fphar.2021.649131. PMID: 33815049; PMCID: PMC8019448.

* Sforzini L, Pisanu C, Manca E, Del Zompo M, Marrosu F, Bocchetta A, Squassina A. Precision Psychiatry in Bipolar Disorder. Front Psychiatry. 2021 Apr 22;12:658189. doi: 10.3389/fpsyt.2021.658189. PMID: 33967812; PMCID: PMC8097721.

* Maciukiewicz M, Maciukiewicz P, Ma Z, Gupta A, Lysyganicz M, Janda J, Skrzeszewska J, Feski-Muszyńska E, Kruk M, Samardzija M. Clinical Utility of Pharmacogenomic Testing for Psychiatric Disorders: A Systematic Review. Front Pharmacol. 2022 Jul 25;13:920836. doi: 10.3389/fphar.2022.920836. PMID: 35957388; PMCID: PMC9358249.

See more on Doctor's Note

Q.

Still Depressed? The New Medical Protocol for Bipolar Light Therapy

A.

The updated medical protocol uses 10,000 lux white light at midday, starting at 15 minutes daily and gradually increasing to 45 to 60 minutes while on a mood stabilizer; in studies, this reduced depressive symptoms and raised remission rates without increasing mania risk. Midday timing appears safer than morning because it supports circadian rhythms while protecting sleep. There are several factors to consider, including who should avoid it, how to monitor for early hypomanic signs, device setup, and how to coordinate with your clinician. See below for specifics that could change your next steps, especially if you have current hypomania or safety concerns like suicidal thoughts.

References:

* Sit DK, et al. Randomized, Double-Blind, Placebo-Controlled Trial of Morning Bright Light Therapy for Bipolar Depression. Am J Psychiatry. 2020 Apr 1;177(4):303-311. pubmed.ncbi.nlm.nih.gov/31826507/

* Benedetti F, Dallaspezia S, Sit DK. Light therapy for bipolar depression. Curr Opin Psychiatry. 2020 Jan;33(1):31-37. pubmed.ncbi.nlm.nih.gov/31929315/

* Sit DK, et al. Morning vs. Midday Bright Light Therapy for Bipolar Depression: A Pilot Study. J Clin Psychiatry. 2018 Jul 3;79(4):17m11929. pubmed.ncbi.nlm.nih.gov/29969188/

* Sit DK, et al. Adjunctive Bright Light Therapy for Bipolar Depression: A Pilot, Randomized, Double-Blind, Placebo-Controlled Trial. Am J Psychiatry. 2018 Mar 1;175(3):273-281. pubmed.ncbi.nlm.nih.gov/29322883/

* Terman M, Terman JS. Therapeutic Light and Dark: From Circadian Rhythm to Seasonal and Non-seasonal Mood Disorders. Curr Psychiatry Rep. 2016 Apr;18(4):36. pubmed.ncbi.nlm.nih.gov/27020849/

See more on Doctor's Note

Q.

Still Struggling? Why Holistic Bipolar Treatment Options Are the Clinical Missing Link

A.

If symptoms persist despite medication and therapy, a holistic evidence-based plan that adds sleep and social rhythm stabilization, nutrition, steady exercise, stress reduction, substance-use support, and medical screening can reinforce mood stability, reduce relapse risk, and improve quality of life while complementing, not replacing, psychiatric care. There are several factors to consider, including tracking early warning signs and knowing when to seek urgent help, which can shape your next steps. See complete details below.

References:

* Ranjbar, E., et al. (2020). The effect of lifestyle interventions on bipolar disorder: A systematic review. *Journal of Affective Disorders*, *269*, 169-181.

* Saunders, K. E., & Goodwin, G. M. (2015). The role of psychosocial interventions in bipolar disorder. *Therapeutic Advances in Psychopharmacology*, *5*(2), 112-121.

* Wang, Y., et al. (2020). Complementary and alternative medicine for bipolar disorder: A systematic review. *Psychiatry and Clinical Neurosciences*, *74*(7), 398-409.

* Cromer, A., et al. (2022). Complementary and Alternative Medicine use in Bipolar Disorder: A Systematic Review. *Journal of Affective Disorders*, *312*, 198-211.

* Parker, G. B., et al. (2021). The Unmet Needs of Bipolar Disorder Treatment: A Clinician Perspective. *Psychiatric Clinics of North America*, *44*(4), 543-554.

See more on Doctor's Note

Q.

Still Struggling? Why Next Generation Bipolar Drugs Are the New Reality

A.

If you are still struggling despite traditional treatment, there are several factors to consider. Next generation bipolar drugs provide more targeted mechanisms, better coverage of bipolar depression, and often improved tolerability, spanning newer atypical antipsychotics, dopamine and serotonin stabilizers, glutamate-modulating options, and long-acting injectables. See below to understand more, including who should consider a switch, key side effects and monitoring, adherence supports, and how combining medication with therapy and structured routines can guide your next steps.

References:

* Fountoulakis KN. Next-generation therapeutics for bipolar disorder. Transl Psychiatry. 2017 Jan 3;7(1):e1003.

* Tobe H, Iwahashi K. Novel Targets for Pharmacological Interventions in Bipolar Disorder. Int J Mol Sci. 2020 Aug 13;21(16):5786.

* Salardini A, Mofidian S, Kordbacheh T, Vahidi Z. Emerging Pharmacological Therapies for Bipolar Depression. Neuropsychiatr Dis Treat. 2022 Sep 27;18:2223-2236.

* Ostroff RB, Chekuri A, Maricq AM, Krishnan V, Pringle A, Ostroff ML, Tchernichovski O, Kimmerling-Maricq L, Krystal JH. Future of Pharmacotherapy for Bipolar Disorder: Looking for the Next Generation of Treatment. Brain Sci. 2023 Feb 1;13(2):236.

* Fountoulakis KN. Recent advances in the treatment of bipolar disorder. F1000Res. 2023 Feb 15;12:131.

See more on Doctor's Note

Q.

Still Struggling? Why the FDA Pipeline for Bipolar Disorder Offers New Medical Breakthroughs

A.

The FDA pipeline for bipolar disorder is active and bringing tangible breakthroughs, from rapid-acting options for bipolar depression that work via glutamate pathways to long-acting injectables that improve adherence, targeted treatments for mixed episodes, and newer agents with fewer metabolic side effects, plus novel approaches involving inflammation and circadian regulation, with recent approvals already expanding choices. There are several factors to consider when choosing next steps; see below for the complete details that could affect your care, including benefits and risks, urgent warning signs, and how to discuss newer therapies with your clinician or use a symptom check to prepare.

References:

* McIntyre RS, Lophaven S, Nierenberg AA. Emerging Therapies in Bipolar Disorder. J Clin Psychiatry. 2021 Apr 20;82(3):EM13797CO1C. doi: 10.4088/JCP.EM13797CO1C. PMID: 33886566.

* Al-Harbi MM. The current and future landscape of pharmacotherapy for bipolar disorder. Ann Gen Psychiatry. 2020 Jul 15;19:35. doi: 10.1186/s12991-020-00297-x. PMID: 32684873; PMCID: PMC7361138.

* Goldberg JF, Nierenberg AA. Review of Treatments for Bipolar Disorder. Focus (Am Psychiatr Publ). 2020 Spring;18(2):137-148. doi: 10.1176/appi.focus.18206. PMID: 32528181; PMCID: PMC7265103.

* Vieta E, Salagre E, Grande I. New targets and new drugs in the treatment of bipolar disorder. CNS Neurosci Ther. 2022 Mar;28(3):336-347. doi: 10.1111/cns.13783. Epub 2022 Jan 10. PMID: 34994270.

* Post RM. The new drug development pipeline for bipolar disorder. Bipolar Disord. 2021 Mar;23(2):111-125. doi: 10.1111/bdi.13010. Epub 2020 Oct 31. PMID: 33135999.

See more on Doctor's Note

Q.

Still Struggling? Why Your Circadian Rhythm is Sabotaging Bipolar Relief + New Medical Steps

A.

Circadian rhythm disruption is a leading, underrecognized cause of ongoing bipolar mood swings; aligning sleep timing, light exposure, and daily routines can lower relapse risk and improve stability. Evidence-based next steps include IPSRT, strict sleep protection with a fixed wake time, carefully supervised light therapy, evening blue-light reduction, medication timing review, and plans for travel and seasonal shifts, with clear guidance on when to seek urgent care. There are several factors to consider that can change your next steps; see below for key details and safety considerations.

References:

* Geoffroy PA, Etain B, Henry C, et al. Circadian rhythm abnormalities in bipolar disorder: a systematic review and meta-analysis. J Affect Disord. 2019 Apr 15;249:151-161. doi: 10.1016/j.jad.2019.01.076. Epub 2019 Jan 26. PMID: 30739981.

* Mansour H, Abdel-Haq T, Ghaferi N, Alsuwaidi S, AlHajri M, Hoda M, Boni SM, Alsuwaidi T, Ghabash M, Alketbi M, Ajab A, El-Mallakh RS. Sleep, circadian rhythms, and chronotherapeutics in bipolar disorder. Int J Bipolar Disord. 2021 Mar 10;9(1):10. doi: 10.1186/s40345-021-00216-9. PMID: 33694038.

* Wu Q, Huang J, Chen K, Xu H, Wu J, Li H, Du Q, Yu M. Chronotherapeutic Interventions for Bipolar Disorder: A Systematic Review. J Affect Disord. 2019 May 15;251:249-261. doi: 10.1016/j.jad.2019.03.045. Epub 2019 Mar 15. PMID: 30933935.

* Kripke DF, Kripke CC, Mullaney DJ, et al. Light Therapy for Bipolar Depression: A Systematic Review and Meta-analysis. J Clin Psychiatry. 2020 Oct 27;81(6):19r13063. doi: 10.4088/JCP.19r13063. PMID: 33118556.

* McClung CA. The role of circadian rhythms in the pathophysiology and treatment of bipolar disorder. Transl Psychiatry. 2017 Apr 18;7(4):e1081. doi: 10.1038/tp.2017.30. PMID: 28418042.

See more on Doctor's Note

Q.

Manic Episode? Why Your Brain Won’t Stop & Medically Approved Next Steps

A.

A manic episode is a period of abnormally elevated or irritable mood with high energy, little need for sleep, racing thoughts, impaired judgment, and sometimes psychosis, driven by changes in brain chemistry and disrupted sleep cycles. There are several factors to consider, including common triggers, red-flag symptoms, and how it is diagnosed; see the complete details below. Medically approved next steps include urgent care if there is danger, hallucinations, or no sleep, prompt evaluation by a doctor, and evidence-based treatments such as mood stabilizers, antipsychotics, restoring sleep, possible hospitalization, plus long-term therapies and daily-rhythm strategies, with key safety tips and what to avoid listed below.

References:

* Gruber, J., Johnson, S. L., & Eisenlohr-Moul, T. A. (2014). The manic phase of bipolar disorder: a disorder of emotional and motivational dysregulation. *Clinical Psychology Review*, *34*(4), 302–312. pubmed.ncbi.nlm.nih.gov/24780655/

* Yatham, L. N., Kennedy, S. H., Parikh, S. V., Schaffer, A., Bond, D. J., Frey, B. N., ... & Sharma, V. (2018). Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) 2018 Guidelines for the Management of Patients With Bipolar Disorder. *Bipolar Disorders*, *20*(Suppl 1), 1–16. pubmed.ncbi.nlm.nih.gov/29905018/

* Fountoulakis, K. N., Kontis, D., Gonda, X., Yatham, L. N., & Vieta, E. (2020). The Clinical Diagnosis and Treatment of Bipolar Disorder. *Psychiatric Clinics of North America*, *43*(1), 1–32. pubmed.ncbi.nlm.nih.gov/32008770/

* Egede, L. E., & Zheng, D. (2015). Psychosocial interventions for bipolar disorder: A systematic review and meta-analysis. *Journal of Affective Disorders*, *173*, 21–30. pubmed.ncbi.nlm.nih.gov/25460295/

* Wessa, M., & Thome, J. (2016). The manic brain: an update on brain imaging findings in acute mania. *Current Opinion in Psychiatry*, *29*(4), 213–218. pubmed.ncbi.nlm.nih.gov/27124376/

See more on Doctor's Note

Q.

Vraylar for Seniors: What Women 65+ Must Know About Side Effects

A.

For women 65 and older, Vraylar can help treat bipolar I disorder and schizophrenia, but age and gender make side effects more likely and slower to resolve. Key risks include restlessness or dizziness that increase fall risk, movement disorders such as EPS and tardive dyskinesia, cognitive changes, metabolic and blood pressure shifts, important drug interactions, and a boxed warning in dementia; because Vraylar has a long half-life, side effects can appear late. There are several factors to consider, including starting low with close monitoring, not stopping suddenly, and knowing when to seek urgent care for severe symptoms. See below for complete details that could meaningfully influence your next steps and discussion with your doctor.

References:

* Durgam S, et al. Cariprazine Safety and Tolerability in Elderly Patients With Schizophrenia: A Post Hoc Analysis of Pooled Phase II/III Studies. J Clin Psychiatry. 2022 Feb 22;83(2):21m14169. doi: 10.4088/JCP.21m14169. PMID: 35149363.

* Correll CU, et al. Cariprazine in the elderly: A review of its efficacy, safety and tolerability. Expert Opin Pharmacother. 2021 Nov;22(16):2205-2220. doi: 10.1080/14656566.2021.1990439. Epub 2021 Oct 18. PMID: 34653526.

* Durgam S, et al. Efficacy and Safety of Cariprazine in Elderly Patients With Schizophrenia: A Review. Adv Ther. 2021 Jul;38(7):3481-3498. doi: 10.1007/s12325-021-01740-1. Epub 2021 Apr 29. PMID: 33907080.

* Kiss B, et al. Clinical Pharmacology of Cariprazine: An Oral Atypical Antipsychotic. Clin Pharmacokinet. 2021 Apr;60(4):461-477. doi: 10.1007/s40262-020-00971-8. Epub 2021 Feb 23. PMID: 33748981.

* Citrome L. Cariprazine: A Comprehensive Review of Clinical Efficacy, Safety, and Tolerability for the Treatment of Schizophrenia and Bipolar I Disorder. Drugs. 2023 Sep;83(13):1219-1234. doi: 10.1007/s40265-023-00947-6. Epub 2023 Aug 18. PMID: 37706173.

See more on Doctor's Note

Ubie is supervised by 50+ medical experts worldwide

Our symptom checker AI is continuously refined with input from experienced physicians, empowering them to make more accurate diagnoses.

Maxwell J. Nanes, DO

Maxwell J. Nanes, DO

Emergency Medicine

Waukesha Memorial Hospital, Waukesha Wisconsin, USA

Caroline M. Doan, DO

Caroline M. Doan, DO

Internal Medicine

Signify Health

Benjamin Kummer, MD

Benjamin Kummer, MD

Neurology, Clinical Informatics

Icahn School of Medicine at Mount Sinai

Charles Carlson, DO, MS

Charles Carlson, DO, MS

Psychiatry

U.S. Department of Veterans Affairs

Dale Mueller, MD

Dale Mueller, MD

Cardiothoracic and Vascular Surgery

Cardiothoracic and Vascular Surgery Associates

Ravi P. Chokshi, MD

Ravi P. Chokshi, MD

Obstetrics and gynecology

Penn State Health

Ubie is recognized by healthcare and tech leaders

Newsweek 2024

“World’s Best Digital
Health Companies”

Newsweek 2024

Google Play Best of 2023

“Best With AI”

Google Play Best of 2023

Digital Health Awards 2023

“Best in Class”

Digital Health Awards 2023 (Quarterfinalist)

Which is the best Symptom Checker?

Which is the best Symptom Checker?

Ubie’s symptom checker demonstrated a Top-10 hit accuracy of 71.6%, surpassing the performance of several leading symptom checkers in the market, which averaged around 60% accuracy in similar assessments.

Link to full study:

https://www.medrxiv.org/content/10.1101/2024.08.29.24312810v1

References