Twelve-month outcome in bipolar patients with and without personality disorders.
BACKGROUND
We studied the 12-month course of illness after hospitalization for patients with a DSM-III-R diagnosis of bipolar disorder, manic or mixed episode, to identify the impact of a co-occurring personality disorder on measures of outcome.


METHODS
Fifty-nine patients with bipolar disorder hospitalized for the treatment of a manic or mixed episode were recruited. Diagnostic, symptomatic, and functional evaluations were obtained at the index hospitalization. Personality disorders were assessed using the Structured Clinical Interview for DSM-III-R, personality disorders version (SCID-II). Patients were then reevaluated at 2, 6, and 12 months after discharge to assess syndromic, symptomatic, and functional recovery. Factors associated with outcome were identified using multivariate analyses.


RESULTS
Survival analyses showed that in the 12-month follow-up period, subjects with bipolar disorder and co-occurring personality disorder were significantly less likely to achieve recovery. Logistic regression analyses indicated that both a diagnosis of personality disorder and noncompliance with treatment were significantly associated with lack of syndromic recovery.


CONCLUSIONS
Co-occurring personality disorders in patients with bipolar disorder are associated with poor outcome after hospitalization for mania.
Dunayevich
E
E
Clinical Psychobiology Program, Department of Psychiatry, University of Cincinnati College of Medicine, Ohio 45267-0559, USA.
Sax
K W
KW
Keck
P E
PE
McElroy
S L
SL
Sorter
M T
MT
McConville
B J
BJ
Strakowski
S M
SM
D000328:Adult; D001714:Bipolar Disorder / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology; D015897:Comorbidity; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization; D006801:Humans; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D010359:Patient Readmission; D010554:Personality Disorders / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D011619:Psychotropic Drugs / Q000627:therapeutic use; D016019:Survival Analysis; D016896:Treatment Outcome; D016312:Treatment Refusal
D011619:Psychotropic Drugs