TY - JOUR
T1 - 15-Year outcome of treated bipolar disorder
AU - Tsai, Shang Ying M
AU - Chen, Chiao Chicy
AU - Kuo, Chian Jue
AU - Lee, Ju Chin
AU - Lee, Hsin Chien
AU - Strakowski, Stephen M.
PY - 2001
Y1 - 2001
N2 - 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.
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.
KW - Bipolar disorder
KW - Compliance
KW - Predictor of long-term outcome
KW - Psychosocial intervention
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U2 - 10.1016/S0165-0327(00)00163-4
DO - 10.1016/S0165-0327(00)00163-4
M3 - Article
C2 - 11246098
AN - SCOPUS:0035089615
VL - 63
SP - 215
EP - 220
JO - Journal of Affective Disorders
JF - Journal of Affective Disorders
SN - 0165-0327
IS - 1-3
ER -