title: The progression of 102 Brazilian patients with bipolar disorder: outcome of first 12 months of prospective follow-up.
abstract: BACKGROUND
  Prospective studies have shown that the course of bipolar disorder (BD) is characterized by the persistence of symptoms, predominantly depression, along most of the time. However, to our knowledge, no studies in Latin America have investigated it.
  
  
  OBJECTIVE
  To replicate international studies using a Brazilian sample to prospectively analyze treatment outcomes in the first year and to determine potential chronicity factors.
  
  
  METHODS
  We followed up 102 patients with BD for 12 months and evaluated the number of months with affective episodes and the intensity of manic and depressive symptoms using the Young Mania Rating Scale (YMRS) and the Hamilton Depression Scale (HAM-D17). Sociodemographic and retrospective clinical data were examined to determine possible predictors of outcome.
  
  
  RESULTS
  Almost 50% of the patients had symptoms about half of the time, and there was a predominance of depressive episodes. Disease duration and number of depressive episodes were predictors of chronicity. Depressive polarity of the first episode and a higher number of depressive episodes predicted the occurrence of new depressive episodes.
  
  
  CONCLUSIONS
  In general, BD outcome seems to be poor in the first year of monitoring, despite adequate treatment. There is a predominance of depressive symptoms, and previous depressive episodes are a predictor of new depressive episodes and worse outcome.
authors.affiliation: Institute of Psychiatry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
authors.forename: Fernanda
authors.initials: F
authors.lastname: Novis
authors.affiliation: Institute of Psychiatry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
authors.forename: Patricia
authors.initials: P
authors.lastname: Cirillo
authors.affiliation: Institute of Psychiatry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
authors.forename: Rafael Assis da
authors.initials: RA
authors.lastname: Silva
authors.affiliation: Institute of Psychiatry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
authors.forename: Ana Letícia
authors.initials: AL
authors.lastname: Santos
authors.affiliation: Institute of Psychiatry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
authors.forename: Luciana Angélica Silva
authors.initials: LA
authors.lastname: Silveira
authors.affiliation: Institute of Psychiatry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
authors.forename: Adriana
authors.initials: A
authors.lastname: Cardoso
authors.affiliation: Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
authors.forename: Pedro
authors.initials: P
authors.lastname: Coscarelli
authors.affiliation: Institute of Psychiatry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
authors.forename: Antônio Egidio
authors.initials: AE
authors.lastname: Nardi
authors.affiliation: Institute of Psychiatry, UERJ, Rio de Janeiro, RJ, Brazil.
authors.forename: Elie
authors.initials: E
authors.lastname: Cheniaux