Abstract

Background: Prior reports suggested that bipolar patients in Taiwan had comparable long-term outcome to Western patients despite markedly lower rates of co-occurring substance use disorders. Thus, predictors of long-term outcome identified from Taiwanese bipolar samples may be less influenced by substance abuse. Methods: One hundred and one patients with bipolar disorder (DSM-III-R) having been naturalistically treated for at least 15 years were recruited. These patients were annually followed for 2 years to assess overall outcome, psychiatric symptoms, rehospitalization, work, and social adjustment. A combination of medical record reviews and direct personal interviews with patients and family members provided the clinical data. Results: Of these patients, 16.8% expressed a poor overall long-term outcome, even though only two (2.0%) patients exhibited alcohol dependence during the follow-up period. Multivariate regression showed that full compliance with medication was the strongest predictor of favorable overall long-term outcome, followed by younger age at onset and male sex. Younger age at onset as well as male sex, but not full compliance, also predicted a favorable psychosocial outcome. Limitations: Recruiting our sample from a clinical population with uncontrollable long-term treatment limits the generalizability of the findings. Conclusions: Compliance with pharmacotherapy is important to achieve a favorable overall long-term outcome of bipolar disorder. A portion of bipolar patients may have an unfavorable psychosocial outcome regardless of the psychopharmacological intervention or presence of substance abuse.

Original languageEnglish
Pages (from-to)215-220
Number of pages6
JournalJournal of Affective Disorders
Volume63
Issue number1-3
DOIs
Publication statusPublished - 2001

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Bipolar Disorder
Substance-Related Disorders
Age of Onset
Social Adjustment
Medication Adherence
Taiwan
Diagnostic and Statistical Manual of Mental Disorders
Alcoholism
Compliance
Medical Records
Psychiatry
Interviews
Drug Therapy
Population

Keywords

  • Bipolar disorder
  • Compliance
  • Predictor of long-term outcome
  • Psychosocial intervention

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Behavioral Neuroscience
  • Biological Psychiatry
  • Neurology
  • Psychology(all)

Cite this

15-Year outcome of treated bipolar disorder. / Tsai, Shang Ying M; Chen, Chiao Chicy; Kuo, Chian Jue; Lee, Ju Chin; Lee, Hsin Chien; Strakowski, Stephen M.

In: Journal of Affective Disorders, Vol. 63, No. 1-3, 2001, p. 215-220.

Research output: Contribution to journalArticle

Tsai, Shang Ying M ; Chen, Chiao Chicy ; Kuo, Chian Jue ; Lee, Ju Chin ; Lee, Hsin Chien ; Strakowski, Stephen M. / 15-Year outcome of treated bipolar disorder. In: Journal of Affective Disorders. 2001 ; Vol. 63, No. 1-3. pp. 215-220.
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AB - Background: Prior reports suggested that bipolar patients in Taiwan had comparable long-term outcome to Western patients despite markedly lower rates of co-occurring substance use disorders. Thus, predictors of long-term outcome identified from Taiwanese bipolar samples may be less influenced by substance abuse. Methods: One hundred and one patients with bipolar disorder (DSM-III-R) having been naturalistically treated for at least 15 years were recruited. These patients were annually followed for 2 years to assess overall outcome, psychiatric symptoms, rehospitalization, work, and social adjustment. A combination of medical record reviews and direct personal interviews with patients and family members provided the clinical data. Results: Of these patients, 16.8% expressed a poor overall long-term outcome, even though only two (2.0%) patients exhibited alcohol dependence during the follow-up period. Multivariate regression showed that full compliance with medication was the strongest predictor of favorable overall long-term outcome, followed by younger age at onset and male sex. Younger age at onset as well as male sex, but not full compliance, also predicted a favorable psychosocial outcome. Limitations: Recruiting our sample from a clinical population with uncontrollable long-term treatment limits the generalizability of the findings. Conclusions: Compliance with pharmacotherapy is important to achieve a favorable overall long-term outcome of bipolar disorder. A portion of bipolar patients may have an unfavorable psychosocial outcome regardless of the psychopharmacological intervention or presence of substance abuse.

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