title: Clinical outcome in bipolar disorder in a community-based follow-up study in Butajira, Ethiopia.
abstract: OBJECTIVE
  To determine the clinical outcome of bipolar disorder in a developing country setup.
  
  
  METHODS
  After assessing 68 378 individuals, aged 15-49 years, in a double-sampling design in a rural community in Ethiopia, 312 patients with bipolar disorder were prospectively monitored with symptom rating scales and clinically for an average of 2.5 years.
  
  
  RESULTS
  Overall, 65.9% of the cohort experienced a relapse--47.8% manic, 44.3% depressive and 7.7% mixed episodes--and 31.1% had persistent illness. Female gender predicted depressive relapse, while male gender predicted manic relapse. Being on psychotropic medication was associated with remission.
  
  
  CONCLUSIONS
  This large community-based study confirms the relapsing nature of bipolar disorder and a tendency for chronicity. This may be partly because of lack of appropriate interventions in this setting; however, it may also indicate the underlying severity of the disorder irrespective of setting.
authors.affiliation: Institute of Psychiatry, Kings College London, London, UK.
authors.forename: A
authors.initials: A
authors.lastname: Fekadu
authors.forename: D
authors.initials: D
authors.lastname: Kebede
authors.forename: A
authors.initials: A
authors.lastname: Alem
authors.forename: D
authors.initials: D
authors.lastname: Fekadu
authors.forename: S
authors.initials: S
authors.lastname: Mogga
authors.forename: A
authors.initials: A
authors.lastname: Negash
authors.forename: G
authors.initials: G
authors.lastname: Medhin
authors.forename: T
authors.initials: T
authors.lastname: Beyero
authors.forename: T
authors.initials: T
authors.lastname: Shibre
mesh_terms: D000293:Adolescent; D000328:Adult; D001714:Bipolar Disorder / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology* / Q000523:psychology; D002908:Chronic Disease; D015331:Cohort Studies; D003431:Cross-Cultural Comparison; D003430:Cross-Sectional Studies; D003906:Developing Countries; D005002:Ethiopia; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011619:Psychotropic Drugs / Q000627:therapeutic use; D012008:Recurrence; D012424:Rural Population / Q000706:statistics & numerical data*; D012737:Sex Factors
chemical_list: D011619:Psychotropic Drugs