Twelve-month outcome in bipolar patients with and without personality disorders
Dunayevich, E.; Sax, K.W.; Keck, P.E.; McElroy, S.L.; Sorter, M.T.; McConville, B.J.; Strakowski, S.M.
Journal of Clinical Psychiatry 61(2): 134-139
2000
ISSN/ISBN: 0160-6689 PMID: 10732661 Document Number: 522039
Background: We studied the 12-month course of illness after hospitalization for patients with a DSM-III-R diagnosis of bipolar disorder, manic or mixed episode, to identify the impact of a co-occurring personality disorder on measures of outcome. Method: Fifty-nine patients with bipolar disorder hospitalized for the treatment of a manic or mixed episode were recruited. Diagnostic, symptomatic, and functional evaluations were obtained at the index hospitalization. Personality disorders were assessed using the Structured Clinical Interview for DSM-III-R, personality disorders version (SCID-II). Patients were then reevaluated at 2, 6, and 12 months after discharge to assess syndromic, symptomatic, and functional recovery. Factors associated with outcome were identified using multivariate analyses. Results: Survival analyses showed that in the 12-month follow-up period, subjects with bipolar disorder and co-occurring personality disorder were significantly less likely to achieve recovery. Logistic regression analyses indicated that both a diagnosis of personality disorder and noncompliance with treatment were significantly associated with lack of syndromic recovery. Conclusion: Co-occurring personality disorders in patients with bipolar disorder are associated with poor outcome after hospitalization for mania.