Early determinants of four‐year clinical outcomes in bipolar disorder with psychosis
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Carlson GA, Kotov R, Chang S‐W, Ruggero C, Bromet EJ. Early determinants of four‐year clinical outcomes in bipolar disorder with psychosis. Bipolar Disord 2012: 14: 19–30. © 2012 The Authors. Journal compilation © 2012 John Wiley & Sons A/S. Objective: Bipolar disorder with psychosis is common in inpatient settings and is associated with diverse outcomes after hospital discharge, which can range from a return to premorbid functioning with no recurrence, to a chronic or recurring illness. Less is known, however, about factors that can predict a better or worse clinical outcome. The present study sought to assess four‐year clinical outcomes and their predictors in patients hospitalized for bipolar I disorder with psychosis. Methods: Participants from the Suffolk County Mental Health Project (SCMHP) with a baseline diagnosis of bipolar I disorder with psychotic features (N = 126) were reassessed using face‐to‐face interviews at six months, two years, and four years following their first hospitalization. At each time point, clinical status, role functioning, and treatment were assessed by highly trained interviewers using standardized instruments. Results: The majority of participants (73.2%) returned to their premorbid level of role functioning by the four‐year follow‐up and the median percentage of time ill during the interval was less than 20%. Nevertheless, almost half of the sample (46.9%) was rehospitalized at least once. Psychotic symptoms at baseline (particularly Schneiderian symptoms), depressive phenomenology, childhood psychopathology, and younger age at first hospitalization predicted worse outcome, whereas mood‐incongruent psychotic features and age of mood disorder onset did not. Conclusions: The four‐year outcomes of a first‐admission cohort with bipolar I disorder with psychosis were generally favorable. Poorer premorbid functioning, Schneiderian delusions, greater depressive symptoms, and a younger age of first hospitalization portend a worse course.
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Risk factors for recurrence in bipolar disorder include younger age of onset, psychotic features, rapid cycling, more and more frequent previous episodes, comorbid anxiety, and comorbid substance use disorders.
“Risk factors for recurrence include younger age of onset,332 psychotic features,212 rapid cycling,331 more (and more frequent) previous episodes,333 comorbid anxiety,334 and comorbid SUDs.335”
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Parikh, S. V., Hawke, L. D., Velyvis, V., Zaretsky, A., Beaulieu, S., Patelis‐Siotis, I., MacQueen, G., Young, L. T., Yatham, L. N., & Cervantes, P. (2015) · Bipolar Disorders · doi:10.1111/bdi.12233 · Cited by 31 · see citing works
- Authors
- Carlson, G. A., Kotov, R., Chang, S., Ruggero, C., & Bromet, E. J.
- Affiliations
- Stony Brook School (US)
- Institute of Biomedical Sciences, Academia Sinica (TW)
- University of North Texas (US)
- Corresponding author
- Carlson, Gabrielle A
- Venue
- Bipolar Disorders
- Publisher
- Wiley
- Published
- 2012-02
- Volume
- 14
- Issue
- 1
- Pages
- 19-30
- ISSN
- 1398-5647 (ISSN-L)
- 1399-5618
- PMC
- PMC3281503
- OpenAlex
- W1912174211
- Cited by
- 49
- References
- 90
- Citations by year
- 2025: 3 · 2024: 3 · 2023: 4 · 2022: 5 · 2021: 2 · 2020: 4 · 2019: 5 · 2018: 5 · 2017: 2 · 2016: 4 · 2015: 3 · 2014: 4 · 2013: 3 · 2012: 2
- FWCI
- 2.73
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Bipolar Disorders (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- Eli Lilly and Company
- National Institute of Mental Health (R01MH044801, R01MH094398, MH44801)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
- Keywords
- bipolar disorder, long-term clinical outcomes, prognostic factors, hospital readmission, premorbid functioning, depressive symptoms, childhood psychopathology, role functioning
- MeSH terms
- Adolescent, Adult, Bipolar Disorder, Delusions, Depression, Female, Follow-Up Studies, Hospitalization, Humans, Longitudinal Studies, Male, Middle Aged, Psychotic Disorders, Recurrence, Risk Factors, Treatment Outcome, Age of Onset, Disease Progression
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