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The Maudsley bipolar disorder project Clinical characteristics of bipolar disorder I in a Catchment area treatment sample

Published online by Cambridge University Press:  16 April 2020

Vanessa Raymont
Affiliation:
Section of Neurobiology of Psychosis, P066, Division of Psychological Medicine, Institute of Psychiatry, De Crespigny Park, LondonSE5 8AF, UK
David Bettany
Affiliation:
Section of Neurobiology of Psychosis, P066, Division of Psychological Medicine, Institute of Psychiatry, De Crespigny Park, LondonSE5 8AF, UK
Sophia Frangou*
Affiliation:
Section of Neurobiology of Psychosis, P066, Division of Psychological Medicine, Institute of Psychiatry, De Crespigny Park, LondonSE5 8AF, UK
*
*E-mail address: s.frangou@iop.kcl.ac.uk
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Abstract

The clinical characteristics of bipolar I disorder (BD1) have prognostic and therapeutic importance. The aim of this study was to examine the effect of demographic and clinical variables on the course of BD1. We reviewed the case notes of all BD1 patients (n = 63) receiving treatment in a London psychiatric service during a 1-month period. Depressive and manic onsets were equally likely without any gender difference. The earlier the age of onset, the more likely it was for patients to experience psychotic features. Only depressive onsets predicted a higher number of episodes of the same polarity. Male gender and substance abuse were associated with younger age at first presentation, while women with co-morbid substance abuse had more manic episodes. Male patients were more likely than females to be unemployed or single.

Type
Original article
Copyright
Copyright © Éditions scientifiques et médicales Elsevier SAS 2003

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References

American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 4th ed. DSM-IV. Washington (DC: American Psychiatric Press; 1994.Google Scholar
Blanco, C, Laje, G, Olfson, M, Marcus, SC, Pincus, HATrends in the treatment of bipolar disorder by outpatient psychiatrists. Am J Psychiatry 2002;159:1005–10.CrossRefGoogle ScholarPubMed
Carlson, GA, Bromet, EJ, Sievers, SPhenomenology and outcome of subjects with early- and adult-onset psychotic mania. Am J Psychiatry 2000;157:213–9.CrossRefGoogle ScholarPubMed
First, MB, Spitzer, RL, Gibbon, M, Williams, JBW. Structured clinical interview for axis I DSM-IV disorders-patient edition (SCID-I/P, Version 2.0). New York: Psychiatric Research Institute; 1994.Google Scholar
Hasin, D, Endicott, J, Lewis, CAlcohol and drug abuse in patients with affective syndromes. Compr Psychiatry 1985;26:283–95.Google ScholarPubMed
Hendrick, V, Altshuler, LL, Gitlin, MJ, Delrahim, S, Hammen, CGender and bipolar illness. J Clin Psychiatry 2000;61:393–6.CrossRefGoogle ScholarPubMed
Hilty, DM, Brady, KT, Hales, REA review of bipolar disorder among adults. Psychiatr Serv 1999;50:201–13.CrossRefGoogle ScholarPubMed
Glover, GR, Robin, E, Emami, J, Arabscheibani, GRA needs index for mental health care. Soc Psychiatry Psychiatr Epidemiol 1998;33: 89–96.CrossRefGoogle ScholarPubMed
Goodwin, FK, Jamison, KRManic-depressive illness. New York: Oxford University Press; 1990.Google Scholar
Jarman, BIdentification of underprivileged areas. BMJ 1983;286: 1705–9.CrossRefGoogle ScholarPubMed
Jones, PB, Bebbington, P, Foerster, A, Lewis, SW, Murray, RM, Rus sell, Aet al. Premorbid social underachievement in schizophrenia. Results from the Camberwell collaborative psychosis study. Br J Psychiatry 1993;162:65–71.CrossRefGoogle ScholarPubMed
Keitner, GI, Solomon, DA, Ryan, CE, Miller, IW, Mallinger, A, Kupfer, DJet al. Prodromal and residual symptoms in bipolar disorder. Compr Psychiatry 1996;37:362–7.CrossRefGoogle Scholar
Kessing, LV. The effect of the first manic episode in affective disorder: a case register study of hospitalised episodes. J Affect Disord 1999; 53:233–9.CrossRefGoogle ScholarPubMed
Johnson, Set al., editors. London commission: London’s mental health. London: King’s Fund; 1997. p. 26.Google Scholar
Kupfer, DJ, Frank, E, Grochocinski, VJ, Cluss, PA, Houck, PR, Stapf, DADemographic and clinical characteristics of individuals in a bipolar disorder case registry. J Clin Psychiatry 2002;63:120–5.CrossRefGoogle Scholar
Leibenluft, EWomen with bipolar illness: clinical and research issues. Am J Psychiatry 1996;153:163–73.Google ScholarPubMed
Lish, JD, Dime-Meenan, S, Whybrow, PC, Price, RA, Hirschfeld, RMA. The national depressive and manic-depressive association (DMDA) survey of bipolar members. J Affect Disord 1994;31:281–94.CrossRefGoogle ScholarPubMed
Maj, M, Pirozzi, R, Magliano, L, Bartoli, LLong-term outcome of lithium prophylaxis in bipolar disorder: a 5-year prospective study of 402 patients at a lithium clinic. Am J Psychiatry 1998;155:30–5.Google Scholar
McElroy, SL, Altshuler, LL, Suppes, T, Keck, PE Jr, Frye, MA, Deni-coff, KDet al. Axis I psychiatric comorbidity and its relationship to historical illness variables in 288 patients with bipolar disorder. Am J Psychiatry 2001;158:420–6.CrossRefGoogle ScholarPubMed
McElroy, SL, Keck, PE Jr, Pope, HG Jr, Hudson, JI, Faedda, GL, Swann, ACClinical and research implications of the diagnosis of dysphoric or mixed mania or hypomania. Am J Psychiatry 1992;149: 1633–44.Google ScholarPubMed
McGlashan, TH. Adolescent versus adult onset mania. Am J Psychiatry 1988;145:221–3.Google Scholar
Mirandola, M, Bisoffi, G, Bonizzato, P, Amaddeo, FCollecting psychiatric resources utilisation data to calculate costs of care: a comparison between a service receipt interview and a case register. Soc Psychiatry Psychiatr Epidemiol 1999;34:541–7.CrossRefGoogle Scholar
Office of Population Censuses and Surveys. Standard occupational classification. London: HMSO; 1991.Google Scholar
Perugi, G, Micheli, C, Akiskal, HS, Madaro, D, Socci, C, Quilici, Cet al. Polarity of the first episode, clinical characteristics, and course of manic depressive illness: a systematic retrospective investigation of 320 bipolar patients. Compr Psychiatry 2000;41:13–8.CrossRefGoogle Scholar
Regier, DA, Farmer, ME, Rae, DSCo-morbidity of mental disorders with alcohol and other drug abuse: results from the epidemiologic Catchment area (ECA) study. JAMA 1990;264:2511–8.CrossRefGoogle ScholarPubMed
Robb, JC, Young, LT, Cooke, RG, Joffe, RTGender differences in patients with bipolar disorder influence outcome in the medical outcomes survey (SF-20) subscale scores. J Affect Disord 1998;49: 189–93.CrossRefGoogle ScholarPubMed
Roy-Byrne, P, Post, RM, Uhde, TW, Porcu, T, Davis, DThe longitudinal course of recurrent affective illness: life chart data from research patients at the NIMH. Acta Psychiatr Scand Suppl 1985;317:5–34.Google ScholarPubMed
Schurhoff, F, Bellivier, F, Jouvent, R Mouren-Simeoni MC, Bouvard, M, Allilaire, JFet al. Early and late onset bipolar disorders: two different forms of manic-depressive illness?. J Affect Disord 2000;58: 215–21.CrossRefGoogle ScholarPubMed
Solomon, DA, Keitner, GI, Miller, IW, Shea, MT, Keller, MBCourse of illness and maintenance treatments for patients with bipolar disorder. J Clin Psychiatry 1995;56:5–13.Google ScholarPubMed
Strakowski, SM, Tohen, M, Stoll, AL, Faedda, GL, Goodwin, DCComorbidity in mania at first hospitalisation. Am J Psychiatry 1992; 149:554–6.Google Scholar
Suppes, T, Leverich, GS, Keck, PE, Nolen, WA, Denicoff, KD, Alt-shuler, LLet al. The Stanley Foundation bipolar treatment outcome network. II. Demographics and illness characteristics of the first 261 patients. J Affect Disord Dec 2001;67(1–3):45–59.CrossRefGoogle ScholarPubMed
Thornicroft, G, Strathdee, G, Phelan, M, Holloway, F, Wykes, T, Dunn, Get al. Rationale and design. PRiSM psychosis study I. Br J Psychiatry 1998;173:363–70.Google ScholarPubMed
Tohen, M, Waternaux, CM, Tsuang, MTOutcome in mania. Arch Gen Psychiatry 1990;47:1106–11.CrossRefGoogle ScholarPubMed
Tohen, M, Hennen, J, Zarate, CM Jr, Baldessarini, RJ, Strakowski, SM, Stoll, ALet al. Two-year syndromal and functional recovery in 219 cases of first-episode major affective disorder with psychotic features. Am J Psychiatry 2000;157:220–8.CrossRefGoogle ScholarPubMed
Winokur, G, Coryell, W, Akiskal, HS, Endicott, J, Keller, M, Mueller, TManic-depressive (bipolar) disorder: the course in light of a prospective 10-year follow-up of 131 patients. Acta Psychiatr Scand 1994;89: 102–10.CrossRefGoogle ScholarPubMed
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