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Phenomenology, socio-demographic factors and outcome upon discharge of manic and mixed episodes in hospitalized adolescents


Brunelle, Julie; Consoli, Angèle; Tanguy, Marie-Laure; Huynh, Christophe; Perisse, Didier; Deniau, Emmanuelle; Guilé, Jean-Marc; Gérardin, Priscille; Cohen, David


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Abstract Background: The existence of bipolar disorder type I (BD-I) during adolescence is now clearly established whereas there are still some controversies on BD-II and BD-NOS diagnosis, mainly in Europe (O'Dowd in Br Med J 29, 2006). Little is known on the phenomenology and potential short-term prognosis factors of bipolar episodes in this age population. In particular, very few studies examine this issue on inpatients in the European context of free access to care. Objective: To describe the phenomenology of acute manic and mixed episodes in hospitalized adolescents and to analyse potential predictive factors associated with clinical improvement at discharge and length of hospitalization. Methods: A total of 80 subjects, aged 12–20 years, consecutively hospitalized for a manic or mixed episode. Socio-demographic and clinical data were extracted by reviewing patients' charts. We used a multivariate analysis to evaluate short-term outcome predictors. Results: The sample was characterized by severe impairment, high rates of psychotic features (N = 50, 62.5%), a long duration of stay (mean 80.4 days), and an overall good improvement (86% very much or much improved). Thirty-three (41.3 %) patients had a history of depressive episodes, 13 (16.3%) had manic or brief psychotic episodes but only 3 (3.7%) had a history of attention deficit/ hyperactivity disorders. More manic episodes than mixed episodes were identified in subjects with mental retardation (MR) and in subjects from migrant and/or low socio-economic families. Overall severity and female gender predicted better improvement in GAF scores. Poor insight and the existence of psychotic features predicted longer duration of stay. Conclusion: These results suggest that severe manic and mixed episodes in adolescents with BD-I need prolonged inpatient care to improve and that socio-cultural factors and MR should be examined more closely in youth with BD.
Klassifikation psychische Störungen, Behandlung und Prävention
Freie Schlagwörter bipolar disorder type I; acute episode; adolescent; prognosis; socio-cultural factors
Sprache Dokument Englisch
Publikationsjahr 2009
Seitenangabe S. 185-193
Zeitschriftentitel European Child & Adolescent Psychiatry, 18 (2009) 3
DOI http://dx.doi.org/10.1007/s00787-008-0715-7
Status Postprint; begutachtet (peer reviewed)
Lizenz PEER Licence Agreement (applicable only to documents from PEER project)