Abstract
OBJECTIVE: To study the long-term follow-up of patients with bipolar disorder (BPD). METHOD: Eleven outpatients with BPD type I were followed up naturalistically for five years at a university teaching hospital. The Clinical Global Impression Scale (BPD version) was used to evaluate the occurrence of affective episodes, and the Strauss-Carpenter Outcome Scale was used to evaluate social and occupational functioning. RESULTS: The majority of patients were symptomatic most of the time, with predominantly depressive episodes. Overall, patients remained euthymic a mean of 47.7% of the time. Despite a low rate of hospitalization, social and occupational functioning was poor in the majority of patients. A poor disease course with respect to work-related functioning was associated with fewer months of euthymia with a longer duration of depressive episodes. The total number of months of euthymia negatively correlated with the patient's age and disease duration. CONCLUSION: Despite the small sample size, the present findings appear to corroborate previous studies on the evolution of BPD. Most of the patients had a poor disease course, with long symptomatic periods, particularly depressive episodes, and significantly impaired social and occupational functioning.
Highlights
The first descriptions of what is referred to as bipolar disorder (BPD) emphasized the more benign nature of the disease compared with schizophrenia
The present study described the first five years of followup of 11 patients with a BPD type I diagnosis treated as outpatients at a university teaching hospital in Rio de Janeiro, Brazil
Depression accounted for 24.4% of the time, whereas mania accounted for 15.5% of the time, and a mixed state accounted for 12.3% of the time
Summary
The first descriptions of what is referred to as bipolar disorder (BPD) emphasized the more benign nature of the disease compared with schizophrenia. The diagnosis of BPD disorder implies a more favorable prognosis than schizophrenia[2]. Several recent studies have shown that BPD prognosis is not as favorable as it was believed some decades ago[3,4,5]. The present study described the first five years of followup of 11 patients with a BPD type I diagnosis treated as outpatients at a university teaching hospital in Rio de Janeiro, Brazil. Scales for the evaluation of symptoms and psychosocial function were regularly applied to analyze the long-term course of the disease in these patients
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