12-MONTH OUTCOME OF PATIENTS WITH BIPOLAR DISORDER FOLLOWING HOSPITALIZATION FOR A MANIC OR MIXED EPISODE

Objective: The authors studied the 12-month course of illness followin g hospitalization for a manic or mixed episode of bipolar disorder to identify, potential outcome predictors. Method: They recruited 134 pat ients with DSM-III-R bipolar disorder who were consecutively admitted for the treatment of a manic or mixed episode. Diagnostic, symptomatic , and functional evaluations were obtained at the index hospitalizatio n. Patients were reevaluated at 2, 6, and 12 months after discharge to assess syndromic, symptomatic, and functional outcome. Factors associ ated with outcome were identified by using multivariate analyses. Resu lts: During the 12-month follow-up period, there were no significant d ifferences in outcome between patients with manic compared with mixed bipolar disorder. Although syndromic recovery occurred in 48% of the o verall group, symptomatic recovery occurred in only 26% and functional recovery in only 24%. Predictors of syndromic recovery included short er duration of illness and full treatment compliance. Medication treat ment compliance was inversely associated with the presence of comorbid substance use disorders. Symptomatic and functional recovery occurred more rapidly and in a greater percentage of patients from higher soci al classes. Conclusions: A minority of patients with bipolar disorder achieved a favorable outcome in the year following hospitalization for a manic or mixed episode. Shorter duration of illness, higher social class, and treatment compliance were associated with higher rates of r ecovery and move rapid recovery.