OUTCOME AND COMORBIDITY IN FIRST-EPISODE COMPARED WITH MULTIPLE-EPISODE MANIA

The aim of this study was to examine the outcome and comorbidity of pa tients with bipolar disorder presenting with first-episode as compared with multiple-episode mania. Based on studies from the prepharmacolog ical era and the sensitization model of bipolar disorder, we hypothesi zed that compared with multiple-episode mania, first-episode mania wou ld be associated with better outcome, milder severity, and less psychi atric comorbidity. Seventy-one hospitalized patients, age 12 years and older and meeting DSM-III-R criteria for bipolar disorder, were recru ited over a 1-year period. Thirty-four (48%) first-episode and 37 (56% ) multiple-episode patients were compared regarding demographics, phen omenology, comorbidity, family history, and short-term course. Compare d with multiple-episode mania, first-episode mania was associated with significantly shorter hospitalization and a higher rate of comorbid i mpulse control disorders. These data provide indirect support for the sensitization model of bipolar disorder.