A team of researchers led by Stony Brook Professor of Psychiatry
Gabrielle Carlson, MD, has identified several factors which predict
clinical outcomes during the four years following an initial
hospitalization with a diagnosis of bipolar disorder with psychosis.
Their findings were published in the February 13, 2012 issue of Bipolar Disorders.
Although
bipolar disorder with psychosis is a common diagnosis for people
admitted for inpatient psychiatric care, few studies have examined
factors other than psychosis which might predict outcomes such as
recurrence of symptoms, rates of rehospitalization, need for treatment,
and overall functioning during the years following the initial
discharge.
Drawing on data from the Suffolk County Mental Health
Project, a large prospective study conducted by the Department of
Psychiatry and Behavioral Science at Stony Brook University, the
researchers analyzed information regarding 126 participants who were
diagnosed with bipolar disorder with psychosis at the time of their
first hospitalization and followed closely by the research team over the
ensuing four years.
The team used bivariate and multiple
regression analyses to examine the associations between various outcomes
and various demographic and clinical factors which might predict them.
These factors included age at the time of first hospitalization, family
history of psychiatric disorder, a history of psychiatric disorder
during childhood, results of psychiatric assessments and medications
prescribed at time of discharge, among others. The team discovered, as
they expected, a complex series of relationships between potential
predictive factors and clinical outcomes. They identified four factors
of particular significance: the type and severity of psychotic symptoms,
factors associated with depression, psychiatric problems in childhood,
and the age at which the illness first occurred. Their findings support
the distinction between primarily manic and primarily depressive
subtypes of bipolar disorder, which tend to have different outcomes.
The
researchers observed that the participants in the study had “a
reasonably positive outcome at four years.” Almost three quarters of the
participants were functioning at approximately the same level as they
were before they entered the hospital. However, almost half of the
participants were rehospitalized at least once and, on average, they
experienced symptoms about a third of the time during the four year
interval.
Drs. Roman Kotov and Evelyn Bromet from the Department
of Psychiatry and Behavioral Science at Stony Brook collaborated with
Dr. Carlson on the study along with Su-Wei Chang from the Academia
Sinica, Nankang, Taipei, Taiwan and Camilo Ruggero from the University
of North Texas. Their article is titled “Early determinants of four-year
clinical outcomes in bipolar disorder with psychosis.” Bipolar Disorders is the official journal of the International Society for Bipolar Disorders.
