The progression of 102 Brazilian patients with bipolar disorder: outcome of first 12 months of prospective follow-up

Abstract

Introduction: Prospective studies have shown that the course of bipolar disorder (BD) is characterized by the persistence of symptoms, predominantly depression, along most of the time. However, to our knowledge, no studies in Latin America have investigated it. Objectives: To replicate international studies using a Brazilian sample to prospectively analyze treatment outcomes in the first year and to determine potential chronicity factors. Methods: We followed up 102 patients with BD for 12 months and evaluated the number of months with affective episodes and the intensity of manic and depressive symptoms using the Young Mania Rating Scale (YMRS) and the Hamilton Depression Scale (HAM-D17). Sociodemographic and retrospective clinical data were examined to determine possible predictors of outcome. Results: Almost 50% of the patients had symptoms about half of the time, and there was a predominance of depressive episodes. Disease duration and number of depressive episodes were predictors of chronicity. Depressive polarity of the first episode and a higher number of depressive episodes predicted the occurrence of new depressive episodes. Conclusion: In general, BD outcome seems to be poor in the first year of monitoring, despite adequate treatment. There is a predominance of depressive symptoms, and previous depressive episodes are a predictor of new depressive episodes and worse outcome.

Lifetime and point prevalence of psychotic symptoms in adults with bipolar disorders: a systematic review and meta-analysis

“…There were 24 studies reporting data on the point prevalence of psychotic symptoms in BD. For an overview of included studies, see online Supplementay Material 5: Studies included in the meta-analyses of the point prevalence of psychotic symptoms in bipolar disorders (Abulseoud et al, 2020;Asaad et al, 2014;Azorin, Adida, & Belzeaux, 2015;Azorin, Akiskal, & Hantouche, 2006;Basterreche et al, 2008;Benazzi, 2001;Bonnin et al, 2015;Caldieraro et al, 2017;Carroll, Vohs, O'Donnell, Shekhar, & Hetrick, 2007;Ciapparelli et al, 2001;Fiedorowicz et al, 2011;Goldberg & Harrow, 2004;Guven, Kesebir, Demirer, & Bilici, 2015;Kessing, 2004;Kessing, Jensen, & Christensen, 2008;Levy & Weiss, 2010;Lindenmayer, Bossie, Kujawa, Zhu, & Canuso, 2008;Lundin, Bartolomeo, O'Donnell, & Hetrick, 2018;Novis et al, 2014;Reddy, Meyer, Wittlin, Miller, & Weinstock, 2017;Salem et al, 2019;Samalin et al, 2014;Schwartzmann et al, 2007;Yildiz, Guleryuz, Ankerst, Ongur, & Renshaw, 2008).…”

“…For the 11 studies (n = 1263) that gave information about the age span for the included patients, the pooled point prevalence was 45% (95% CI 32-59) (Abulseoud et al, 2020;Asaad et al, 2014;Azorin et al, 2006;Caldieraro et al, 2017;Guven et al, 2015;Levy & Weiss, 2010;Lundin et al, 2018;Novis et al, 2014;Salem et al, 2019;Schwartzmann et al, 2007;Yildiz et al, 2008).…”

“…The pooled point prevalence for psychotic symptoms in the 20 studies using DSM BD diagnoses (n = 4856) was 41.5% (95% CI 32-52) (Abulseoud et al, 2020;Asaad et al, 2014;Azorin et al, 2006Azorin et al, , 2015Basterreche et al, 2008;Benazzi, 2001;Bonnin et al, 2015;Caldieraro et al, 2017;Carroll et al, 2007;Ciapparelli et al, 2001;Guven et al, 2015;Levy & Weiss, 2010;Lindenmayer et al, 2008;Lundin et al, 2018;Novis et al, 2014;Reddy et al, 2017;Salem et al, 2019;Samalin et al, 2014;Schwartzmann et al, 2007;Yildiz et al, 2008).…”

“…Out of these 20 studies, in the 12 studies (N = 3359) of at least moderate quality, the pooled point prevalence was 38% (95% CI 27-50) (Abulseoud et al, 2020;Asaad et al, 2014;Azorin et al, 2006Azorin et al, , 2015Basterreche et al, 2008;Benazzi, 2001; Caldieraro et al, 2017;Guven et al, 2015;Lundin et al, 2018;Novis et al, 2014;Samalin et al, 2014).…”

Living with bipolar disorder in Chile: A qualitative study

“…In addition, BD with other comorbid mental illnesses is prevalent in emergency rooms in Latin American countries (Castilla‐Puentes et al ). Besides, a 12‐month study of clients with BD in Brazil showed a predominant recurrence of depressive episodes (Novis et al ). Vázquez et al () in their quantitative study have proven an association between self‐perceived stigma and poor functioning clients with BD, being the only research in Latin America where this association could be demonstrated.…”