L V Kessing1, P K Andersen. 1. Department of Psychiatry, University of Copenhagen, Rigshospitalet, Denmark. lars.kessing@dadlnet.dk
Abstract
BACKGROUND: The risk of recurrence has been found to increase with the number of episodes in both unipolar and bipolar affective disorder. The present study compared the effect of the number of episodes on the risk of recurrence in the two disorders. METHOD: A case register study including all hospital admissions with primary affective disorder in Denmark during 1971-1993. The effect of the number of prior episodes on the rate of recurrence following the first discharge after 1984 was estimated. A total of 7925 unipolar patients and 2011 bipolar patients were included in the study. RESULTS: The rate of recurrence was, on average, 1.6 times greater for bipolar patients than for unipolar patients. Nevertheless, the effect of the number of episodes was greatest for unipolar patients. Thus, the rate of recurrence increased, on average, 15% with every episode for unipolar patients and 9% with every episode for bipolar patients, when adjusted for differences in age and gender. CONCLUSION: The risk of recurrence increases with every new episode in affective disorder. The effect of episodes is greater for unipolar disorder than for bipolar disorder. LIMITATIONS: The data relate to re-admissions rather than recurrence. CLINICAL RELEVANCE: The study shows that the prognosis worsens more for unipolar than for bipolar patients with each new episode and suggests the relevance of earlier and more sustained intervention.
BACKGROUND: The risk of recurrence has been found to increase with the number of episodes in both unipolar and bipolar affective disorder. The present study compared the effect of the number of episodes on the risk of recurrence in the two disorders. METHOD: A case register study including all hospital admissions with primary affective disorder in Denmark during 1971-1993. The effect of the number of prior episodes on the rate of recurrence following the first discharge after 1984 was estimated. A total of 7925 unipolar patients and 2011 bipolarpatients were included in the study. RESULTS: The rate of recurrence was, on average, 1.6 times greater for bipolarpatients than for unipolar patients. Nevertheless, the effect of the number of episodes was greatest for unipolar patients. Thus, the rate of recurrence increased, on average, 15% with every episode for unipolar patients and 9% with every episode for bipolarpatients, when adjusted for differences in age and gender. CONCLUSION: The risk of recurrence increases with every new episode in affective disorder. The effect of episodes is greater for unipolar disorder than for bipolar disorder. LIMITATIONS: The data relate to re-admissions rather than recurrence. CLINICAL RELEVANCE: The study shows that the prognosis worsens more for unipolar than for bipolarpatients with each new episode and suggests the relevance of earlier and more sustained intervention.
Authors: Giacomo Salvadore; Wayne C Drevets; Ioline D Henter; Carlos A Zarate; Husseini K Manji Journal: Early Interv Psychiatry Date: 2008-08 Impact factor: 2.732