title: Bipolar disorder and its outcomes: two cohorts, 1875-1924 and 1994-2007, compared.
abstract: We compared admission rates and outcomes for bipolar disorder patients using the medical records of patients with a first hospital admission in 1875-1924 retrospectively diagnosed based on International Classification of Diseases (ICD)-10 criteria, and patients with a first admission in 1994-2007. The incidences of first admissions in the historical and contemporary periods are comparable: 1.2 and 1.3 per hundred thousand per year, respectively. Manic episodes constituted a greater proportion of admissions historically, while depressive episodes made up more in the contemporary sample. There is no evidence for a reduction in the mean inter-admission intervals with duration of illness. This study suggests that modern treatments may have decreased lengths of stay in hospital, but at a cost of contributing to more admissions. It also points to a shift in the threshold for admissions.
authors.affiliation: North Wales Department of Psychological Medicine, Hergest Unit, Bangor, Wales.
authors.forename: Onome V
authors.initials: OV
authors.lastname: Atigari
authors.affiliation: North Wales Department of Psychological Medicine, Hergest Unit, Bangor, Wales.
authors.forename: Margaret
authors.initials: M
authors.lastname: Harris
authors.affiliation: North Wales Department of Psychological Medicine, Hergest Unit, Bangor, Wales.
authors.forename: Joanna
authors.initials: J
authors.lastname: Le Noury
authors.affiliation: North Wales Department of Psychological Medicine, Hergest Unit, Bangor, Wales David.Healy54@googlemail.com.
authors.forename: David
authors.initials: D
authors.lastname: Healy
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001714:Bipolar Disorder / Q000266:history / Q000628:therapy*; D003695:Delivery of Health Care / Q000266:history / Q000592:standards; D003863:Depression; D005260:Female; D049672:History, 19th Century; D049673:History, 20th Century; D049674:History, 21st Century; D006760:Hospitalization; D006801:Humans; D007902:Length of Stay; D008297:Male; D008605:Mental Health Services / Q000266:history; D008875:Middle Aged; D010343:Patient Admission; D016896:Treatment Outcome; D055815:Young Adult
keywords: Bipolar disorder; hospitalization; incidence; manic-depressive illness; outcomes; relapse