title: ‎ Recurrence in Patients with Bipolar Disorder and Its Risk Factors.
abstract: Objective:The aim of this study was to identify prognosis factors associated with recurrence in patients ‎with bipolar disorder.‎‎Method:This retrospective cohort study was conducted in Hamadan Province, the west of Iran. All ‎patients (n = 400) with bipolar disorder who were hospitalized for the second time or more ‎during April 2008 to September 2014 were included in this study. Ordinal logistic regression ‎analysis was employed to determine the effective factors in each recurrence, and odds ratio (OR) and 95% confidence intervals (CI) were obtained.‎Results:The mean (SD) age of the participants at the entrance to the study was 34.62 (11.68) years. ‎There was an association between recurrence and type of bipolar disorder (P = 0.033). The ‎OR of recurrence was 0.28 (95% CI: 0.09, 0.90) for bipolar disorder II; 0.35 (95% CI: 0.13, ‎‎0.92) for the patients‎‏ ‏with college education; 0.39 (95% CI: 0.25, 0.60) for employed ‎patients; 0.55 (95% CI: 0.35, 0.87) for patients who received both drugs and ‎electroconvulsive therapy, and 1.89 (95% CI: 1.23, 2.92) for patients who stopped using ‎drugs. In addition, a non-significant association was found between recurrence and age, sex, ‎marital status, place of residence, season, mood classification and family history of mood ‎disorder.‎Conclusion:Type of bipolar disorder and cessation of medication were the leading causes of an increase in ‎the relapse of the disease. Furthermore, patients who received both drugs and ‎electroconvulsive therapy had a fewer risk of recurrence.‎.
authors.affiliation: Department of Biostatistics, School of Public Health, Hamadan University of Medical ‎Sciences, Hamadan, Iran. Email: n_vosough@yahoo.com.
authors.forename: Roya
authors.initials: R
authors.lastname: Najafi-Vosough
authors.affiliation: Behavioral Disorders and Substance Abuse Research Center, Hamadan University of Medical ‎Sciences, Hamadan, Iran. Email: ‎dralighaleiha@gmail.com.
authors.forename: Ali
authors.initials: A
authors.lastname: Ghaleiha
authors.affiliation: Department of Biostatistics, School of Public Health, Hamadan University of Medical ‎Sciences, Hamadan, Iran. Email: n_vosough@yahoo.com; Modeling of Noncommunicable Diseases Research Center, Hamadan University of Medical Sciences, Hamadan, Iran. Email: javad.faradmal@umsha.ac.ir ‎.
authors.forename: Javad
authors.initials: J
authors.lastname: Faradmal
authors.affiliation: Department of Biostatistics, School of Public Health, Hamadan University of Medical ‎Sciences, Hamadan, Iran. Email: n_vosough@yahoo.com; Research Center for Health Sciences, Hamadan University of Medical Sciences, Hamadan, Iran.
authors.forename: Hossein
authors.initials: H
authors.lastname: Mahjub
keywords: Bipolar Disorder; Ordinal Logistic Regression; Prognosis Factors; Recurrence