Remission and recurrence in bipolar disorder: The data from health outcomes and patient evaluations in bipolar disorder (HOPE-BD) study.
Alcohol use disorder
Anxiety disorders
Bipolar disorder
Early-onset
Recurrence
Remission
Substance use disorders
Journal
Journal of affective disorders
ISSN: 1573-2517
Titre abrégé: J Affect Disord
Pays: Netherlands
ID NLM: 7906073
Informations de publication
Date de publication:
01 05 2020
01 05 2020
Historique:
received:
01
12
2019
revised:
27
02
2020
accepted:
04
03
2020
pubmed:
17
3
2020
medline:
16
2
2021
entrez:
17
3
2020
Statut:
ppublish
Résumé
The HOPE-BD was a naturalistic study established to follow individuals in Canada seeking treatment for bipolar disorder (BD). The study aimed to examine the course of BD and describe how clinical and sociodemographic factors are associated with outcomes. Individuals with BD had their clinical data recorded at enrolment and were naturalistically treated. Participant were followed for up to four years, and visits occurred at least once every three months. We investigated the longitudinal outcomes with logistic, Cox, and quantile regressions. Among the 354 participants, 57.3% had BD type I. Depression as first episode, younger ages at onset and older ages of the first professional help predicted longer delays in correct diagnosis. Among the symptomatic patients at baseline, the median time to remission was 10.9 months. Comorbid alcohol use disorder and the severity of baseline depressive symptoms predicted longer times to remission. Among the euthymic participants, the median time to recurrence was 14.5 months. History of anxiety disorder and younger ages at onset predicted shorter times to recurrence. Baseline depression scores predicted recurrence in euthymic patients. We did not investigate the predictors of each polarity. Our findings may not apply to individuals followed in non-specialised outpatient services. Our study reinforces the necessity of early diagnosis and interventions, as well as the importance of treating depressive symptoms and comorbidities.
Sections du résumé
BACKGROUND
The HOPE-BD was a naturalistic study established to follow individuals in Canada seeking treatment for bipolar disorder (BD). The study aimed to examine the course of BD and describe how clinical and sociodemographic factors are associated with outcomes.
METHODS
Individuals with BD had their clinical data recorded at enrolment and were naturalistically treated. Participant were followed for up to four years, and visits occurred at least once every three months. We investigated the longitudinal outcomes with logistic, Cox, and quantile regressions.
RESULTS
Among the 354 participants, 57.3% had BD type I. Depression as first episode, younger ages at onset and older ages of the first professional help predicted longer delays in correct diagnosis. Among the symptomatic patients at baseline, the median time to remission was 10.9 months. Comorbid alcohol use disorder and the severity of baseline depressive symptoms predicted longer times to remission. Among the euthymic participants, the median time to recurrence was 14.5 months. History of anxiety disorder and younger ages at onset predicted shorter times to recurrence. Baseline depression scores predicted recurrence in euthymic patients.
LIMITATIONS
We did not investigate the predictors of each polarity. Our findings may not apply to individuals followed in non-specialised outpatient services.
CONCLUSION
Our study reinforces the necessity of early diagnosis and interventions, as well as the importance of treating depressive symptoms and comorbidities.
Identifiants
pubmed: 32174473
pii: S0165-0327(19)33360-9
doi: 10.1016/j.jad.2020.03.018
pii:
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
150-157Informations de copyright
Copyright © 2020 Elsevier B.V. All rights reserved.
Déclaration de conflit d'intérêts
Declaration of Competing Interest AD, GS, JK, JVP, NW, PC, SVP, and VS reported no biomedical financial interests or potential conflicts of interest. MKS is on speaker or advisory boards for, or has received research grants from NARSAD, Stanley Medical Research Institute, and Eli-Lilly. LNY been on speaker/advisory boards for, or has received research grants from Alkermes, AstraZeneca, Bristol Myers Squibb, CANMAT, CIHR, DSP, Eli Lilly, GlaxoSmithKline, Janssen, the Michael Smith Foundation for Health Research, Pfizer, Servier, Sunovion, and the Stanley Foundation. SG is on speaker or advisory boards for, or has received research grants from Allergan, CIHR, Janssen-Ortho, Lundbeck, NARSAD, Otsuka, Pfizer Research Award, Sunovion.