title: A medium-term follow-up study of a cohort of Chinese patients after first hospitalisation in a gazetted hospital for mania.
abstract: OBJECTIVE
  To study the characteristics of a cohort of first-episode manic patients treated in a regional psychiatric unit in Hong Kong, to explore the predictors of re-admission, and to investigate their functional outcomes 4 years after first hospitalisation.
  
  
  METHODS
  This was a medium-term follow-up study, using retrospective review of hospital records and clinical interviews at follow-up. Forty-four Chinese patients diagnosed as having their first-episode mania were discharged from a gazetted psychiatric ward in Hong Kong between January 1999 and June 2002. Their clinical characteristics on admission and prescribed medications on discharge were investigated. Their re-admission status was charted. The patients were contacted for follow-up assessment of their functional outcome at 4 years after their first hospitalisation.
  
  
  RESULTS
  In our cohort of 44 patients, their first-episode mania mostly presented in young adulthood, as significantly disturbed behaviour deemed to require compulsory admission. Nineteen (43%) of the patients were re-admitted at least once within 4 years of being discharged, 6 of whom were re-admitted more than once. Compulsory admission at the first-episode mania predicted future re-admission. Alcohol and substance abuse were associated with earlier re-admission after the first-episode mania. None of the patients died. For those who were reassessed (28 patients), most lived with family members. In all, 21 patients were able to sustain open employment at 4 years after discharge. About half (n = 14) of the traceable patients were able to continue in full-time employment at 4 years, while 7 were doing part-time work. The median Global Assessment of Functioning score of the traceable group was 88.
  
  
  CONCLUSIONS
  The results of this local study on patients with their first-episode of hospitalisation for mania were comparable to findings reported in western studies.
authors.affiliation: Department of Psychiatry, Pamela Youde Nethersole Eastern Hospital, 3 Lok Man Road, Chai Wan, Hong Kong. cheuky02@msn.com
authors.forename: K Y
authors.initials: KY
authors.lastname: Cheung
authors.forename: E L W
authors.initials: EL
authors.lastname: Dunn