Heterogeneity of admission history among patients with bipolar disorder

Patients on a first admission for bipolar disorder often have a history of other psychiatric diagnoses for previous admissions.

The current study examines the time course and diagnoses of psychiatric admissions prior and subsequent to a first hospitalisation for a diagnosis of bipolar disorder.

The prior admission histories (over the period 1965-1989) of 1167 patients who had been hospitalised in state mental health facilities with their first admission with diagnosis of bipolar disorder between 1983 and 1989 were examined.

A total of 542 (46.4%) patients had at least one previous hospitalisation with a psychiatric diagnosis other than bipolar disorder. Two prominent groups emerged; one group which had primarily a history of prior admissions with diagnoses of depression over 1-3 years, and a second which mainly had previous admissions for schizophrenia, over a period longer than for those with a primarily depressive history. The group with a history of schizophrenia was significantly younger and had a greater number of admissions prior to the first bipolar disorder diagnosis than the depression group.

This was a record-based study which did not examine cases which were not hospitalised.

There appeared to be three distinct patterns of prior presentations in those patients admitted with a diagnosis of bipolar disorder.