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Outcome in Mania. A 4-year prospective follow-up of 75 patients utilizing survival analysis
M Tohen1, C M Waternaux, M T Tsuang
1Department of Psychiatry, Harvard School of Medicine, Boston, Mass.
Abstract:
A 4-year follow-up of 75 patients was conducted to investigate outcome after recovery from an episode of mania. Predictors of an unfavorable outcome included poor occupational status prior to index episode, history of previous episodes, history of alcoholism, psychotic features and symptoms of depression during the index manic episode, male gender, and interepisode affective symptoms at 6 months' follow-up. The mortality risk during the follow-up period was 4%. The identification of specific risk factors depended on the definition of outcome and the length of follow-up.
Insights
This study followed 75 patients for 4 years after mania recovery. Poor occupational status, prior episodes, alcoholism, and psychotic depression symptoms predicted unfavorable outcomes.
Area of Science:
- Psychiatry
- Clinical Psychology
- Neuroscience
Background:
- Bipolar disorder mania episodes can have long-term consequences.
- Understanding predictors of poor outcomes is crucial for patient management.
Purpose of the Study:
- To investigate the long-term outcomes after recovery from a manic episode.
- To identify predictors of unfavorable outcomes and mortality risk.
Main Methods:
- A 4-year follow-up study.
- Involved 75 patients recovering from a manic episode.
- Assessed various clinical and demographic factors.
Main Results:
- Unfavorable outcomes were linked to poor pre-episode occupational status, prior episodes, alcoholism, psychotic depression during mania, male gender, and interepisode affective symptoms.
- Mortality risk during the follow-up was 4%.
Conclusions:
- Several factors predict long-term unfavorable outcomes after mania.
- Risk factor identification is dependent on outcome definition and follow-up duration.