title: Bipolar I: a five-year prospective follow-up.
abstract: We explored the course of bipolar I illness in 172 probands who were followed up prospectively for up to 5 years. Probands were grouped into three categories based on whether the symptoms of the index episode were only depressed, only manic, or mixed/cycling. Data were available for recovery from the index episode, subsequent relapse, and rates of recovery from the first prospective episode. Pure manic probands had a significantly faster rate of recovery (median, 6 weeks) than the mixed/cycling probands (median, 17 weeks), and the pure depressive probands had an intermediate rate (median, 11 weeks). After 5 years of follow-up the mixed/cycling patients continue to have the lowest cumulative probability of recovery from the index episode. Mixed/cycling probands also had a substantially faster time to relapse after recovery from the index episode compared with pure manic patients. For those patients who relapsed, the mixed/cycling patients had the lowest cumulative probability of recovery from the first prospectively observed episode. The treatment received by these patients is described and there is a discussion of how this treatment may have influenced the findings on course and outcome.
authors.affiliation: Department of Psychiatry and Human Behavior, Brown University, Providence, Rhode Island 02906.
authors.forename: M B
authors.initials: MB
authors.lastname: Keller
authors.forename: P W
authors.initials: PW
authors.lastname: Lavori
authors.forename: W
authors.initials: W
authors.lastname: Coryell
authors.forename: J
authors.initials: J
authors.lastname: Endicott
authors.forename: T I
authors.initials: TI
authors.lastname: Mueller
mesh_terms: D014150:Antipsychotic Agents / Q000627:therapeutic use; D001714:Bipolar Disorder / Q000175:diagnosis* / Q000523:psychology / Q000628:therapy; D003131:Combined Modality Therapy; D003866:Depressive Disorder / Q000175:diagnosis / Q000523:psychology / Q000628:therapy; D004565:Electroconvulsive Therapy; D005500:Follow-Up Studies; D006801:Humans; D011336:Probability; D011379:Prognosis; D011446:Prospective Studies; D011613:Psychotherapy; D012008:Recurrence; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D014150:Antipsychotic Agents