Twelve Month Outcome of Adolescents with Bipolar Disorder Following First-Hospitalization for a Manic or Mixed EpisodeAuthor InfoSocial Media
2006, MS, University of Cincinnati, Medicine : Epidemiology (Environmental Health).
Objective: Although adolescent-onset bipolar disorder is associated with significant morbidity there have been few prospective outcome studies of this population. The aim of this study was to examine the 12-month outcome of adolescents with bipolar disorder following their initial hospitalization for a manic or mixed episode. Method: Bipolar adolescents (N=71) were recruited during their first hospitalization for a manic or mixed episode and were evaluated using diagnostic, symptomatic, and functional assessments. Patients were also evaluated at 1, 4, 8, and 12 months after hospitalization to assess syndromic, symptomatic, and functional outcomes. Predictors of each type of outcome were identified. Results: Kaplan-Meier estimates of the cumulative probabilities of syndromal, symptomatic, and functional recovery, and syndromic relapse (in adolescents who experienced syndromal recovery) during the first 12-months following initial hospitalization were 0.86, 0.43, 0.41, and 0.48, respectively. Only 35% of bipolar adolescents reported full medication adherence. Individual predictors of syndromic recovery included the absence of co-occurring attention deficit/hyperactivity disorder (ADHD), anxiety disorders, and disruptive behavior disorders, as well as, full psychotropic medication adherence and higher socioeconomic levels. Treatment with an antidepressant and co-occurring alcohol use disorders predicted syndromic relapse. Boys were more than twice as likely as girls to experience symptomatic recovery. Although no predictors of overall functional recovery were identified, predictors of specific domains of functional recovery were explored. Conclusions: Most bipolar adolescents experienced syndromic recovery following first hospitalization. However, rates of symptomatic and functional recoveries were much lower. Future studies examining effective treatment strategies for bipolar youth with co-occurring disorder and investigating the factors that contribute to the development of substance use disorders and treatment adherence in bipolar youth are necessary to improve outcome.
Dr. Rakesh Shukla (Advisor)
Bipolar disorder; outcome; adolescents
DelBello, M. (2006). Twelve Month Outcome of Adolescents with Bipolar Disorder Following First-Hospitalization for a Manic or Mixed Episode. (Electronic Thesis or Dissertation). Retrieved from https://etd.ohiolink.edu/
DelBello, Melissa. "Twelve Month Outcome of Adolescents with Bipolar Disorder Following First-Hospitalization for a Manic or Mixed Episode." Electronic Thesis or Dissertation. University of Cincinnati, 2006. OhioLINK Electronic Theses and Dissertations Center. 24 Apr 2014.
DelBello, Melissa P. "Twelve Month Outcome of Adolescents with Bipolar Disorder Following First-Hospitalization for a Manic or Mixed Episode." Electronic Thesis or Dissertation. University of Cincinnati, 2006. https://etd.ohiolink.edu/