15-year outcome of treated bipolar disorder.
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.


CONCLUSIONS
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.
Department of Psychiatry, Taipei Medical College and Hospital, 252 Wu-Hsing Street, Taipei 110, Taiwan. tmcpsyts@tmc.edu.tw
S M
SM
Tsai
C
C
Chen
C
C
Kuo
J
J
Lee
H
H
Lee
S M
SM
Strakowski
D000328:Adult; D017668:Age of Onset; D018692:Antimanic Agents / Q000627:therapeutic use*; D001714:Bipolar Disorder / Q000188:drug therapy* / Q000208:ethnology / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D019966:Substance-Related Disorders; D013624:Taiwan / Q000208:ethnology; D016896:Treatment Outcome
D018692:Antimanic Agents