title: Outcome and comorbidity in first- compared with multiple-episode mania.
abstract: The aim of this study was to examine the outcome and comorbidity of patients with bipolar disorder presenting with first-episode as compared with multiple-episode mania. Based on studies from the prepharmacological era and the sensitization model of bipolar disorder, we hypothesized that compared with multiple-episode mania, first-episode mania would be associated with better outcome, milder severity, and less psychiatric comorbidity. Seventy-one hospitalized patients, age 12 years and older and meeting DSM-III-R criteria for bipolar disorder, were recruited over a 1-year period. Thirty-four (48%) first-episode and 37 (56%) multiple-episode patients were compared regarding demographics, phenomenology, comorbidity, family history, and short-term course. Compared with multiple-episode mania, first-episode mania was associated with significantly shorter hospitalization and a higher rate of comorbid impulse control disorders. These data provide indirect support for the sensitization model of bipolar disorder.
authors.affiliation: Department of Psychiatry, University of Cincinnati College of Medicine, Ohio 45267-0559, USA.
authors.forename: P E
authors.initials: PE
authors.lastname: Keck
authors.forename: S L
authors.initials: SL
authors.lastname: McElroy
authors.forename: S M
authors.initials: SM
authors.lastname: Strakowski
authors.forename: S A
authors.initials: SA
authors.lastname: West
authors.forename: J M
authors.initials: JM
authors.lastname: Hawkins
authors.forename: T J
authors.initials: TJ
authors.lastname: Huber
authors.forename: R M
authors.initials: RM
authors.lastname: Newman
authors.forename: M
authors.initials: M
authors.lastname: DePriest
mesh_terms: D000328:Adult; D017668:Age of Onset; D001714:Bipolar Disorder / Q000175:diagnosis / Q000453:epidemiology*; D015897:Comorbidity; D007174:Disruptive, Impulse Control, and Conduct Disorders / Q000175:diagnosis / Q000453:epidemiology; D005190:Family; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology; D008959:Models, Neurological; D011569:Psychiatric Status Rating Scales; D012008:Recurrence; D012720:Severity of Illness Index