Medication use patterns and 2-year outcome in first-admission bipolar disorder with psychotic features
Abstract
This study examined the patterns and predictors of medication use and 24-month course/outcome in first-admission patients with bipolar disorder (BD) with psychotic features. An epidemiologic sample of 155 first-admission patients with research diagnoses of BD with psychotic features received intensive clinical assessments at baseline, 6- and 24-month follow-ups and telephone assessments at 3-month intervals. Use of antipsychotics, antimanic agents (lithium and anticonvulsants), and antidepressants was determined from self-reports corroborated by external sources where possible. Outcome was assessed with the Global Assessment of Functioning (GAF), consensus evaluations of illness course, and time in remission. More patients received antipsychotics (80.0%) than antimanics (52.3%) at discharge. At the 24-month point, 44.6% reported using no medications; 19.4 and 38.8% received antipsychotics and antimanics, respectively. Health insurance and early regular antimanic use were the strongest predictors of regular antimanic use during the 6-24-month follow-up. Early and later regular use of antimanics and less use of antipsychotics were associated with higher GAF scores and greater time in remission. Conversely, failure to use antimani...Continue Reading
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