Personality disorder among youth with first episode psychotic mania: An important target for specific treatment?
bipolar disorder
depression
first episode
mania
personality disorder
Journal
Early intervention in psychiatry
ISSN: 1751-7893
Titre abrégé: Early Interv Psychiatry
Pays: Australia
ID NLM: 101320027
Informations de publication
Date de publication:
03 2022
03 2022
Historique:
revised:
16
02
2021
received:
05
11
2020
accepted:
12
03
2021
pubmed:
27
3
2021
medline:
12
3
2022
entrez:
26
3
2021
Statut:
ppublish
Résumé
Personality disorder is a common co-occurrence ('comorbidity') among patients with bipolar disorder and appears to affect outcome negatively. However, there is little knowledge about the impact of this comorbidity in the early phases of bipolar disorder. We examined the prevalence and effect of personality disorder co-occurrence on outcome in a cohort of youth with first episode mania with psychotic features. Seventy-one first episode mania patients, aged 15-29, were assessed at baseline, 6, 12, and 18 months as part of a randomized controlled trial of olanzapine and chlorpromazine as add-on to lithium in first episode mania with psychotic features. The current study involved secondary analysis of trial data. A co-occurring clinical personality disorder diagnosis was present in 16.9% of patients. Antisocial and narcissistic personality disorders were the most common diagnoses. Patients with co-occurring personality disorder had higher rates of readmission to hospital, lower rates of symptomatic recovery and poorer functional levels at 6 months, but these differences disappeared after 12 and 18 months. In the early phase of bipolar disorder, patients with personality disorder comorbidity display delayed symptomatic and functional recovery and increased likelihood to need hospital readmissions. These observations suggest that routine assessment for personality disorder and specific interventions are important in order to improve short-term treatment efficacy in this subgroup.
Substances chimiques
Olanzapine
N7U69T4SZR
Types de publication
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
256-263Informations de copyright
© 2021 John Wiley & Sons Australia, Ltd.
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