The McLean-Harvard First-Episode Mania Study: Prediction of Recovery and First Recurrence

Mauricio Tohen, Carlos A. Zarate, John Hennen, Hari-Mandir Kaur Khalsa, Stephen M. Strakowski, Priscilla Gebre-Medhin, Paola Salvatore, Ross J. Baldessarini
2003 American Journal of Psychiatry  
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 of outcomes. Three aspects of recovery were measured: syndromal (DSM-IV criteria for disorder no
more » ... er met), symptomatic (Young Mania Rating Scale score ≤5 and Hamilton Depression Rating Scale score ≤8), and functional (regaining of premorbid occupational and residential status). Rates of remission (syndromal recovery sustained ≥8 weeks), switching (onset of new dissimilar illness before recovery), relapse (new episode of mania within 8 weeks of syndromal recovery), and recurrence (new episode postremission) were also assessed. Results : B y 2 ye a rs , m o s t s u b j e c t s achieved syndromal recovery (98%, with 50% achieving recovery by 5.4 weeks); 72% achieved symptomatic recovery. Factors associated with a shorter time to syn-Am J Psychiatry 160:12, December 2003 EARLY COURSE IN BIPOLAR I DISORDER
doi:10.1176/appi.ajp.160.12.2099 pmid:14638578 fatcat:2cir63kksnat5g2rdeswjqva3u