title: Pharmacotherapy in bipolar disorders during hospitalization and at discharge predicts clinical and psychosocial functioning at follow-up.
abstract: OBJECTIVE
  Individuals with bipolar disorder (BD) usually report significant disability and psychosocial impairment. Both the nature and causes associated with this impairment are poorly understood. In particular, research examining the impact of pharmacotherapy on the different aspects of psychosocial functioning in bipolar patients is currently lacking. The aim of this study was to assess to what extent the psychotropic medications used during psychiatric hospitalization and at discharge can predict clinical psychosocial functioning and the severity of the illness at follow-up in inpatients with bipolar disorder (BD).
  
  
  METHODS
  Patients were 71 adult BD patients contacted on average 31 months after discharge who completed at the follow-up a telephone interview based on the Health of the Nation Outcome Scales (HoNOS).
  
  
  RESULTS
  All the subjects completed the follow-up assessment between 5 and 75 months after discharge. The mean raw score for the HoNOS-6 was 5.70 ± 5.37. Patients with more severe behavior problems more often had been prescribed atypical antipsychotics and anticonvulsants at discharge. Patients with more severe psychosocial functioning problems more often had a history of suicide attempts, and were more often prescribed anxiolytics during hospitalization and less often prescribed lithium at discharge.
  
  
  CONCLUSIONS
  Having been prescribed anxiolytics and atypical antipsychotics during hospitalization predicted reduced psychosocial functioning, whereas prescription of lithium at discharge was associated with better psychosocial functioning at follow-up. Future studies are needed in order to investigate how psychosocial functioning may be related in the long-term to pharmacological treatment in patients after discharge.
authors.affiliation: Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy.
authors.forename: Maurizio
authors.initials: M
authors.lastname: Pompili
authors.forename: Marco
authors.initials: M
authors.lastname: Innamorati
authors.forename: Xenia
authors.initials: X
authors.lastname: Gonda
authors.forename: Gianluca
authors.initials: G
authors.lastname: Serafini
authors.forename: Denise
authors.initials: D
authors.lastname: Erbuto
authors.forename: Federica
authors.initials: F
authors.lastname: Ricci
authors.forename: Kostas N
authors.initials: KN
authors.lastname: Fountoulakis
authors.forename: David
authors.initials: D
authors.lastname: Lester
authors.forename: Gustavo
authors.initials: G
authors.lastname: Vazquez
authors.forename: Zoltan
authors.initials: Z
authors.lastname: Rihmer
authors.forename: Mario
authors.initials: M
authors.lastname: Amore
authors.forename: Paolo
authors.initials: P
authors.lastname: Girardi
mesh_terms: D000328:Adult; D014151:Anti-Anxiety Agents / Q000627:therapeutic use*; D000927:Anticonvulsants / Q000627:therapeutic use*; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D001714:Bipolar Disorder / Q000175:diagnosis / Q000188:drug therapy*; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization; D006801:Humans; D007406:Interview, Psychological; D016014:Linear Models; D018020:Lithium Compounds / Q000627:therapeutic use; D008297:Male; D011379:Prognosis; D011569:Psychiatric Status Rating Scales; D012720:Severity of Illness Index; D013406:Suicide, Attempted
chemical_list: D014151:Anti-Anxiety Agents; D000927:Anticonvulsants; D014150:Antipsychotic Agents; D018020:Lithium Compounds
keywords: bipolar disorder; follow-up; outcome; pharmacotherapy