Four-year follow-up of twenty-four first-episode manic patients.

Twenty-four first-episode manic patients were followed to investigate the 4-year outcome after recovery from a manic episode. Patients had no documented previous manic or depressive episodes. The presence of psychotic features during the index episode and a history of alcoholism were statistically significant predictors of a shorter time in remission. Low occupational status at baseline predicted poor global social adjustment at 4 years. Also, a larger correlation among outcome measures was found at 48 than at 6 months. The importance of controlling for presence of multiple episodes in outcome studies is emphasized.