Correlates of 1-year prospective outcome in bipolar disorder: Results from the Stanley Foundation Bipolar Network

Willem A. Nolen, David A. Luckenbaugh, Lori L. Altshuler, Trisha Suppes, Susan L. McElroy, Mark A Frye, Ralph W. Kupka, Paul E. Keck, Gabriele S. Leverich, Robert M. Post

Research output: Contribution to journalArticle

120 Citations (Scopus)

Abstract

Objective: The purpose of the study was to examine potential correlates of outcome in patients treated for bipolar disorder. Method: During a 1-year period, 258 patients with DSM-IV bipolar disorder or schizoaffective disorder were rated with the prospective NIMH-Life Chart Method, which characterizes each day in terms of the severity of manic and depressive symptoms on the basis of patients' mood-related impairment in their usual educational, social, or occupational roles. Mean ratings for the severity of mania, depression, and overall bipolar illness and the number of manic, depressive, and overall illness episodes were calculated. Potential risk factors were assessed at the start of the study, and multivariate linear regression analysis was used to determine the correlates of the six 1-year outcome measures. Results: Three of the six outcome measures were largely independent of each other and were used in the analysis. The mean rating for severity of mania was associated with comorbid substance abuse, history of more than 10 prior manic episodes, and poor occupational functioning at study entry. The mean rating for severity of depression was associated with a history of more than 10 prior depressive episodes and poor occupational functioning at study entry. The total number of overall illness episodes was associated with a positive family history of drug abuse, a history of prior rapid cycling, and poor occupational functioning. In addition, the mean rating for severity of mania and the total number of overall illness episodes were both initially associated with a history of childhood abuse, but these relationships were lost with the addition of other illness variables to the analysis. Conclusions: Clinicians who treat patients with bipolar disorder should consider a family history of drug abuse, a history of childhood abuse, prior course of illness, comorbid substance abuse, and occupational functioning in determining prognosis and setting goals for further treatment.

Original languageEnglish (US)
Pages (from-to)1447-1454
Number of pages8
JournalAmerican Journal of Psychiatry
Volume161
Issue number8
DOIs
StatePublished - Aug 2004
Externally publishedYes

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Bipolar Disorder
Substance-Related Disorders
Outcome Assessment (Health Care)
Depression
National Institute of Mental Health (U.S.)
Diagnostic and Statistical Manual of Mental Disorders
Psychotic Disorders
Linear Models
Regression Analysis

ASJC Scopus subject areas

  • Psychiatry and Mental health

Cite this

Correlates of 1-year prospective outcome in bipolar disorder : Results from the Stanley Foundation Bipolar Network. / Nolen, Willem A.; Luckenbaugh, David A.; Altshuler, Lori L.; Suppes, Trisha; McElroy, Susan L.; Frye, Mark A; Kupka, Ralph W.; Keck, Paul E.; Leverich, Gabriele S.; Post, Robert M.

In: American Journal of Psychiatry, Vol. 161, No. 8, 08.2004, p. 1447-1454.

Research output: Contribution to journalArticle

Nolen, WA, Luckenbaugh, DA, Altshuler, LL, Suppes, T, McElroy, SL, Frye, MA, Kupka, RW, Keck, PE, Leverich, GS & Post, RM 2004, 'Correlates of 1-year prospective outcome in bipolar disorder: Results from the Stanley Foundation Bipolar Network', American Journal of Psychiatry, vol. 161, no. 8, pp. 1447-1454. https://doi.org/10.1176/appi.ajp.161.8.1447
Nolen, Willem A. ; Luckenbaugh, David A. ; Altshuler, Lori L. ; Suppes, Trisha ; McElroy, Susan L. ; Frye, Mark A ; Kupka, Ralph W. ; Keck, Paul E. ; Leverich, Gabriele S. ; Post, Robert M. / Correlates of 1-year prospective outcome in bipolar disorder : Results from the Stanley Foundation Bipolar Network. In: American Journal of Psychiatry. 2004 ; Vol. 161, No. 8. pp. 1447-1454.
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abstract = "Objective: The purpose of the study was to examine potential correlates of outcome in patients treated for bipolar disorder. Method: During a 1-year period, 258 patients with DSM-IV bipolar disorder or schizoaffective disorder were rated with the prospective NIMH-Life Chart Method, which characterizes each day in terms of the severity of manic and depressive symptoms on the basis of patients' mood-related impairment in their usual educational, social, or occupational roles. Mean ratings for the severity of mania, depression, and overall bipolar illness and the number of manic, depressive, and overall illness episodes were calculated. Potential risk factors were assessed at the start of the study, and multivariate linear regression analysis was used to determine the correlates of the six 1-year outcome measures. Results: Three of the six outcome measures were largely independent of each other and were used in the analysis. The mean rating for severity of mania was associated with comorbid substance abuse, history of more than 10 prior manic episodes, and poor occupational functioning at study entry. The mean rating for severity of depression was associated with a history of more than 10 prior depressive episodes and poor occupational functioning at study entry. The total number of overall illness episodes was associated with a positive family history of drug abuse, a history of prior rapid cycling, and poor occupational functioning. In addition, the mean rating for severity of mania and the total number of overall illness episodes were both initially associated with a history of childhood abuse, but these relationships were lost with the addition of other illness variables to the analysis. Conclusions: Clinicians who treat patients with bipolar disorder should consider a family history of drug abuse, a history of childhood abuse, prior course of illness, comorbid substance abuse, and occupational functioning in determining prognosis and setting goals for further treatment.",
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AU - Suppes, Trisha

AU - McElroy, Susan L.

AU - Frye, Mark A

AU - Kupka, Ralph W.

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AU - Leverich, Gabriele S.

AU - Post, Robert M.

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N2 - Objective: The purpose of the study was to examine potential correlates of outcome in patients treated for bipolar disorder. Method: During a 1-year period, 258 patients with DSM-IV bipolar disorder or schizoaffective disorder were rated with the prospective NIMH-Life Chart Method, which characterizes each day in terms of the severity of manic and depressive symptoms on the basis of patients' mood-related impairment in their usual educational, social, or occupational roles. Mean ratings for the severity of mania, depression, and overall bipolar illness and the number of manic, depressive, and overall illness episodes were calculated. Potential risk factors were assessed at the start of the study, and multivariate linear regression analysis was used to determine the correlates of the six 1-year outcome measures. Results: Three of the six outcome measures were largely independent of each other and were used in the analysis. The mean rating for severity of mania was associated with comorbid substance abuse, history of more than 10 prior manic episodes, and poor occupational functioning at study entry. The mean rating for severity of depression was associated with a history of more than 10 prior depressive episodes and poor occupational functioning at study entry. The total number of overall illness episodes was associated with a positive family history of drug abuse, a history of prior rapid cycling, and poor occupational functioning. In addition, the mean rating for severity of mania and the total number of overall illness episodes were both initially associated with a history of childhood abuse, but these relationships were lost with the addition of other illness variables to the analysis. Conclusions: Clinicians who treat patients with bipolar disorder should consider a family history of drug abuse, a history of childhood abuse, prior course of illness, comorbid substance abuse, and occupational functioning in determining prognosis and setting goals for further treatment.

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