Course and outcome after the first manic episode in patients with bipolar disorder: prospective 12-month data from the Systematic Treatment Optimization Program For Early Mania project

Can J Psychiatry. 2009 Feb;54(2):105-12. doi: 10.1177/070674370905400208.

Abstract

Objective: To describe clinical characteristics, course, and outcome during a 1-year period after the first manic episode in patients with bipolar disorder (BD).

Methods: This paper describes the project design, demographics, clinical outcomes, and predictors at 6 months to 1 year of follow-up of the first 53 recruited subjects with first-episode mania from the Systematic Treatment Optimization Program for Early Mania.

Results: Survival analysis for recurrence of mood episodes showed that 46.7% of patients survived without a mood episode during 1-year of follow-up, and the mean time-to-mood event was 7.9 months. Earlier age of onset was the only variable that significantly predicted recurrence of mood episodes. When examined separately, the survival rates were 76% for a manic episode and 58.7% for a depressive episode.

Conclusion: These results suggest that recurrences are common after the first manic episode with more than one-half of the patients experiencing a mood event within 12 months. Aggressive treatment strategies aimed at preventing depressive episodes are needed in the management of early course BD.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Anticonvulsants / adverse effects
  • Anticonvulsants / therapeutic use
  • Antidepressive Agents / adverse effects
  • Antidepressive Agents / therapeutic use
  • Antimanic Agents / adverse effects
  • Antimanic Agents / therapeutic use*
  • Antipsychotic Agents / adverse effects
  • Antipsychotic Agents / therapeutic use
  • Bipolar Disorder / diagnosis
  • Bipolar Disorder / drug therapy*
  • Bipolar Disorder / epidemiology
  • Bipolar Disorder / genetics
  • Cross-Sectional Studies
  • Female
  • Follow-Up Studies
  • Genetic Predisposition to Disease / genetics
  • Genetic Predisposition to Disease / psychology
  • Humans
  • Male
  • Medication Adherence / statistics & numerical data
  • Patient Education as Topic
  • Prospective Studies
  • Psychiatric Status Rating Scales / statistics & numerical data
  • Psychometrics
  • Recurrence
  • Survival Analysis
  • Young Adult

Substances

  • Anticonvulsants
  • Antidepressive Agents
  • Antimanic Agents
  • Antipsychotic Agents