title: Heterogeneity of admission history among patients with bipolar disorder.
abstract: BACKGROUND
  Patients on a first admission for bipolar disorder often have a history of other psychiatric diagnoses for previous admissions.
  
  
  OBJECTIVE
  The current study examines the time course and diagnoses of psychiatric admissions prior and subsequent to a first hospitalisation for a diagnosis of bipolar disorder.
  
  
  METHODS
  The prior admission histories (over the period 1965-1989) of 1167 patients who had been hospitalised in state mental health facilities with their first admission with diagnosis of bipolar disorder between 1983 and 1989 were examined.
  
  
  RESULTS
  A total of 542 (46.4%) patients had at least one previous hospitalisation with a psychiatric diagnosis other than bipolar disorder. Two prominent groups emerged; one group which had primarily a history of prior admissions with diagnoses of depression over 1-3 years, and a second which mainly had previous admissions for schizophrenia, over a period longer than for those with a primarily depressive history. The group with a history of schizophrenia was significantly younger and had a greater number of admissions prior to the first bipolar disorder diagnosis than the depression group.
  
  
  CONCLUSIONS
  This was a record-based study which did not examine cases which were not hospitalised.
  
  
  CONCLUSIONS
  There appeared to be three distinct patterns of prior presentations in those patients admitted with a diagnosis of bipolar disorder.
authors.affiliation: Discipline of Psychiatry, University of Tasmania, GPO Box 252-27, Hobart, Tas. 7001, Australia. brett.daniels@uta.edu.au
authors.forename: Brett A
authors.initials: BA
authors.lastname: Daniels
authors.forename: Kenneth C
authors.initials: KC
authors.lastname: Kirkby
authors.forename: Philip
authors.initials: P
authors.lastname: Mitchell
authors.forename: David
authors.initials: D
authors.lastname: Hay
authors.forename: Alison
authors.initials: A
authors.lastname: Bowling
mesh_terms: D000328:Adult; D017668:Age of Onset; D001714:Bipolar Disorder / Q000523:psychology / Q000628:therapy*; D003866:Depressive Disorder / Q000175:diagnosis; D005260:Female; D006801:Humans; D008297:Male; D008487:Medical History Taking; D008875:Middle Aged; D010343:Patient Admission / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012307:Risk Factors; D012559:Schizophrenia / Q000175:diagnosis