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Recurrence in affective disorder: analyses with frailty models.
L V Kessing1, E W Olsen, P K Andersen
1Department of Psychiatric Demography, University of Aarhus, Psychiatric Hospital, Risskov, Denmark.
American Journal of Epidemiology
|March 6, 1999
Summary
The risk of affective disorder recurrence increases with more episodes, especially for bipolar disorder patients and women with unipolar disorder. Individual frailty also plays a role in recurrence rates.
Area of Science:
- Psychiatry
- Epidemiology
- Biostatistics
Background:
- Recurrence risk in affective disorders is influenced by episode history and individual susceptibility.
- Understanding these factors is crucial for effective long-term management of affective disorders.
Purpose of the Study:
- To estimate the effect of the number of prior episodes on affective disorder recurrence rates.
- To account for individual frailty (tendency toward recurrence) in recurrence risk models.
Main Methods:
- Utilized newly developed frailty models.
- Analyzed data from the Danish psychiatric case register (1971-1993).
- Included 20,350 first-admission patients diagnosed with major affective disorder.
Main Results:
- For women with unipolar disorder and all bipolar disorder patients, recurrence rates were significantly affected by the number of prior episodes, even after adjusting for frailty.
- Unipolar men showed no effect of episode number but a strong influence of the frailty parameter on recurrence.
Conclusions:
- The risk of affective disorder recurrence generally increases with the number of episodes, particularly in bipolar disorder and for women with unipolar disorder.
- Individual frailty is a significant factor, especially in unipolar men, influencing recurrence risk independently of episode count.