51 patients who were admitted for their first manic episode were followed up for 4 years after discharge from the hospital. 32 (62.7%) patients came for regular follow-ups whereas 19 (37.3%) patients did not come for any follow up. 19 (59.4%) patients out of the 32 patients had subsequent recurrences. 8 (25.0%) patients had a single recurrence only, whereas 11 (34.4%) patients had multiple recu...

BACKGROUND Lamotrigine has been shown to be an effective treatment for bipolar depression and rapid cycling in placebo-controlled clinical trials. This double-blind, placebo-controlled study was conducted to assess the efficacy and tolerability of lamotrigine and lithium compared with placebo for the prevention of relapse or recurrence of mood episodes in recently manic or hypomanic patients wi...

OBJECTIVE Since improved prediction of illness course early in bipolar disorder is required to guide treatment planning, the authors evaluated recovery, first recurrence, and new illness onset following first hospitalization for mania. METHOD Bipolar disorder patients (N=166) were followed 2-4 years after their first hospitalization for a manic or mixed episode to assess timing and predictors...

BACKGROUND Long-term outcomes are often poor in patients with bipolar disorder despite treatment; more effective treatments are needed to reduce recurrences and morbidity. This study compared the efficacy of divalproex, lithium, and placebo as prophylactic therapy. METHODS A randomized, double-blind, parallel-group multicenter study of treatment outcomes was conducted over a 52-week maintenan...

BACKGROUND Studies on the 'self-medication hypothesis' have focused on substance abuse as an attempt to alleviate emotional suffering. METHODS We have investigated concomitant substances of abuse in 150 bipolar heroin addicts clustered according to their clinical presentation at treatment entry (depressive episode, hypomanic episode, manic episode and mixed episode). Bipolar heroin addicted p...

OBJECTIVES This study focused on social support and social strain and their cross-sectional associations with instabilities in sleep and social rhythms in inter-episode bipolar disorder (BD). METHODS Thirty-five adults diagnosed with inter-episode BD type I and 38 healthy controls completed measures of perceived social support and social strain. Group differences in support and strain were ex...

OBJECTIVES As only a few studies so far systematically reported on bipolar patients subtyped according to first-episode polarity, we took the opportunity of having at disposal a large sample of bipolar I patients to specify the characteristics of patients included in these subtypes, with a special focus on temperament and triggering events. METHODS A total of 1089 consecutive DSM-IV bipolar I...

BACKGROUND Cannabis use has been reported to be associated with an earlier onset of symptoms in patients with first-episode psychosis, and a worse outcome in those who continue to take cannabis. In general, studies have concentrated on symptoms of psychosis rather than mania. In this study, using a longitudinal design in a large naturalistic cohort of patients with first-episode psychosis, we i...

BACKGROUND Valproate is one of the most used mood stabilisers for bipolar disorder, although the evidence for the effectiveness of valproate is sparse. AIMS To compare the effect of valproate v. lithium for treatment of bipolar disorder in clinical practice. METHOD An observational cohort study with linkage of nationwide registers of all people with a diagnosis of bipolar disorder in psychi...