2-Year course of bipolar disorder type I patients in outpatient care: factors associated with remission and functional recovery.
EMBLEM is a 2-year, prospective, observational study that enrolled patients initiating/changing oral treatment for an acute manic/mixed episode. This paper analysed remission and functional recovery in 1656 patients who entered the 2-year long-term phase. Cox models identified variables significantly associated with achieving remission and functional recovery at 2years. Of these patients, 64% achieved remission and 34% achieved functional recovery. Patients with a higher CGI-BP overall score at baseline, who had depressive episodes in the year before inclusion and who had poor social functioning (work or social impairment, not living independently or without a spouse/partner) were less likely to achieve remission or recovery. Prescription of typical antipsychotics and prescription of antidepressants at the first visit of the long-term treatment phase (12weeks) were independent predictors of lower remission and recovery rates. In conclusion, functional recovery occurred in approximately half of those who achieved remission. Impairment of work and social functioning was consistently associated with lower remission and recovery rates.
Parc Sanitari Sant Joan De Deu-SSM, Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Sant Boi de Llobregat, Barcelona, Spain. jmharo@comb.es
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Haro
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Reed
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Gonzalez-Pinto
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Novick
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Bertsch
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Vieta
D000328:Adult; D000553:Ambulatory Care; D000928:Antidepressive Agents / Q000627:therapeutic use; D018692:Antimanic Agents / Q000627:therapeutic use*; D014150:Antipsychotic Agents / Q000627:therapeutic use; D001714:Bipolar Disorder / Q000188:drug therapy* / Q000534:rehabilitation; D039721:Diagnostic and Statistical Manual of Mental Disorders; D004651:Employment / Q000523:psychology; D005060:Europe; D005260:Female; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D012074:Remission Induction
D000928:Antidepressive Agents; D018692:Antimanic Agents; D014150:Antipsychotic Agents