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February 13, 2007

Bipolar disorder doesn't just "go away"

On the "Live, Survive, Thrive" blog - there is an interesting blog entry that we thought conveyed something that would be of interest to everyone:

A recent study conducted under clinical criteria highlighted something terrifying for those of us who live with, love someone with, or care for people in our community with bipolar disorder.

(extract)

Relapse and impairment in bipolar disorder

MJ Gitlin, J Swendsen, TL Heller and C Hammen
Department of Psychiatry, University of California, Los Angeles 90024- 6968, USA.

OBJECTIVE: The purpose of this study was to evaluate the outcome of bipolar disorder in the context of maintenance pharmacotherapy.

METHOD: Eighty-two bipolar outpatients were followed prospectively for a mean of 4.3 years (minimum of 2 years); symptom rating and psychosocial outcome scales were used, and pharmacotherapy was rated on a 5-point scale.

RESULTS: Despite continual maintenance treatment, survival analysis indicated a 5-year risk of relapse into mania or depression of 73%. Of those who relapsed, two-thirds had multiple relapses. Relapse could not be attributed to inadequate medication. Even for those who did not relapse, considerable affective morbidity was observed. A measure of cumulative affective morbidity appeared to be a more sensitive correlate of psychosocial functioning than was the number of relapses. Poor psychosocial outcome paralleled poor syndromal course. Poor psychosocial functioning, especially occupational disruption, predicted a shorter time to relapse. Depressions were most strongly related to social and family dysfunction.

CONCLUSIONS: Even aggressive pharmacological maintenance treatment does not prevent relatively poor outcome in a significant number of bipolar patients.

Read the full blog entry: Bipolar disorder doesn’t just ‘go away’

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