TY  - JOUR
PY  - 2019//
TI  - A 12-month prospective study on the time to hospitalization and clinical management of a cohort of bipolar type I and schizoaffective bipolar patients
JO  - European psychiatry
A1  - Murru, Andrea
A1  - Verdolini, Norma
A1  - Anmella, Gerard
A1  - Pacchiarotti, Isabella
A1  - Samalin, Ludovic
A1  - Aedo, Alberto
A1  - Undurraga, Juan
A1  - Goikolea, José M.
A1  - Amann, Benedikt L.
A1  - Carvalho, André F.
A1  - Vieta, Eduard
SP  - 1
EP  - 8
VL  - 61
IS  - 
N2  - BACKGROUND: Schizoaffective disorder, bipolar type (SAD) and bipolar disorder I (BD) present a large clinical overlap. In a 1-year follow-up, we aimed to evaluate days to hospitalization (DTH) and predictors of relapse in a SAD-BD cohort of patients.  METHODS: A 1-year, prospective, naturalistic cohort study considering DTH as primary outcome and incidence of direct and indirect measures of psychopathological compensation as secondary outcomes. Kaplan-Meyer survival analysis with Log-rank Mantel-Cox test compared BD/SAD subgroups as to DTH. After bivariate analyses, Cox regression was performed to assess covariates possibly associated with DTH in diagnostic subgroups.  RESULTS: Of 836 screened patients, 437 were finally included (SAD = 105; BD = 332). Relapse rates in the SAD sample was n = 26 (24.8%) vs. n = 41 (12.3%) in the BD sample (p = 0.002). Mean ± SD DTH were 312.16 ± 10.6 (SAD) vs. 337.62 ± 4.4 (BD) days (p = 0.002). Patients with relapses showed more frequent suicide acts, violent behaviors, and changes in pharmacological treatments (all p < 0.0005) in comparison to patients without relapse. Patients without relapses had significantly higher mean number of treatments at T0 (p = 0.010). Cox regression model relating the association between diagnosis and DTH revealed that BD had higher rates of suicide attempts (HR = 13.0, 95%CI = 4.0-42.0, p < 0.0005), whereas SAD had higher rates of violent behavior during psychotic episodes (HR = 12.0, 95%CI = .3.3-43.5, p > 0.0005).  CONCLUSIONS: SAD patients relapse earlier with higher hospitalization rates and violent behavior during psychotic episodes whereas bipolar patients have more suicide attempts. Psychiatric/psychological follow-up visits may delay hospitalizations by closely monitoring symptoms of self- and hetero-aggression.<p /> <p>Language: en</p>
LA  - en
SN  - 0924-9338
UR  - http://dx.doi.org/10.1016/j.eurpsy.2019.06.001
ID  - ref1
ER  -