The Bipolar Comprehensive Outcomes Study (BCOS): baseline findings of an Australian cohort study.
BACKGROUND
The Bipolar Comprehensive Outcomes Study (BCOS) is a 2-year, observational study of participants with bipolar I or schizoaffective disorder examining clinical, functional, and economic outcomes associated with naturalistic treatment.


METHODS
Participants prescribed mood stabilisers were assessed using various measures, including the Young Mania Rating Scale (YMRS), 21-item Hamilton Depression Rating scale (HAMD21), Clinical Global Impressions-Bipolar Version Severity of Illness scale (CGI-BP), and the EuroQol instrument (EQ-5D).


RESULTS
240 participants were recruited from two sites. On average, participants were 41.8+/-12.7 years of age (mean+/-SD), 58.3% were female, and 73.3% had a diagnosis of bipolar I disorder at study entry. The majority of participants were moderately ill, with an average CGI-BP Overall score of 3.8+/-1.3. Most participants had subthreshold mania and depression symptoms, indicated by HAMD21 Total 13.4+/-8.6, CGI-BP Depression 3.2+/-1.3, YMRS Total 8.2+/-8.5 and CGI-BP Mania 3.0+/-1.6 average scores. For bipolar participants, 94.6% of hospitalisations for psychiatric treatment in the past 3 months were single admissions (vs. 65.2% for schizoaffective participants, p=.002). Bipolar participants rated their overall health state higher (EQ-5D scores: 68.2+/-18.8 vs. 61.6+/-22.7, p=.023), had a higher mean weekly wage ($500-$999, 21.3% vs. 6.3%), lower unemployment (22.2% vs. 48.4%), and higher romantic relationship status (47.1% vs. 26.6%).


CONCLUSIONS
The observational design and small sample size may have limited the causal relationships and generalisability within the current findings.


CONCLUSIONS
Participants were characterised by social and occupational dysfunction at entry, but schizoaffective participants appeared to be more severely affected. Effective treatment is required to address both clinical and functional impairment.
Kulkarni
Jayashri
J
Alfred Psychiatry Research Centre, The Alfred and Monash University, School of Psychology, Psychiatry & Psychological Medicine, Commercial Road, Melbourne VIC 3004, Australia. j.kulkarni@alfred.org.au
Berk
Michael
M
Fitzgerald
Paul B
PB
de Castella
Anthony R
AR
Montgomery
William
W
Kelin
Katarina
K
Brnabic
Alan
A
Granger
Renee E
RE
Dodd
Seetal
S
D000328:Adult; D000368:Aged; D000927:Anticonvulsants / Q000627:therapeutic use; D014150:Antipsychotic Agents / Q000627:therapeutic use; D001315:Australia; D001569:Benzodiazepines / Q000627:therapeutic use; D001714:Bipolar Disorder / Q000175:diagnosis / Q000188:drug therapy* / Q000523:psychology*; D002220:Carbamazepine / Q000627:therapeutic use; D015331:Cohort Studies; D005260:Female; D006304:Health Status; D006801:Humans; D016651:Lithium Carbonate / Q000627:therapeutic use; D008297:Male; D000077152:Olanzapine; D017063:Outcome Assessment, Health Care; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D011618:Psychotic Disorders / Q000175:diagnosis / Q000188:drug therapy / Q000523:psychology; D011788:Quality of Life; D012720:Severity of Illness Index; D012917:Social Adjustment; D016896:Treatment Outcome; D014635:Valproic Acid / Q000627:therapeutic use
D000927:Anticonvulsants; D014150:Antipsychotic Agents; D001569:Benzodiazepines; D016651:Lithium Carbonate; D002220:Carbamazepine; D014635:Valproic Acid; D000077152:Olanzapine