This Article  • References  • Full text PDF  • Reply to article  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Social Bookmarking   What's this?

A 4-Year Prospective Follow-up of 75 Patients Utilizing Survival Analysis

Mauricio Tohen, MD, DrPH; Christine M. Waternaux, PhD; Ming T. Tsuang, MD, PhD, DSc

Arch Gen Psychiatry. 1990;47(12):1106-1111.

Abstract
• A 4-year follow-up of 75 patients was conducted to investigate outcome after recovery from an episode of mania. Predictors of an unfavorable outcome included poor occupational status prior to index episode, history of previous episodes, history of alcoholism, psychotic features and symptoms of depression during the index manic episode, male gender, and interepisode affective symptoms at 6 months' follow-up. The mortality risk during the follow-up period was 4%. The identification of specific risk factors depended on the definition of outcome and the length of follow-up.

Author Affiliations
From the Departments of Psychiatry and Epidemiology, Harvard Program in Psychiatric Epidemiology, Harvard School of Medicine and Harvard School of Public Health, Boston, Mass (Drs Tohen, Waternaux, and Tsuang); Mailman Research Center and Psychotic Disorders Program, McLean Hospital, Belmont, Mass (Drs Tohen and Waternaux); and the Psychiatry Service, Brockton/West Roxbury (Mass) Veterans Administration Center (Dr Tsuang).

Footnotes
Accepted for publication March 1, 1990.

Reprint requests to McLean Hospital, 115 Mill St, Belmont, MA 02178 (Dr Tohen).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Risk of rehospitalization among bipolar disorder patients who are nonadherent to antipsychotic therapy after hospital discharge
Hassan and Lage
Am J Health Syst Pharm 2009;66:358-365.
ABSTRACT | FULL TEXT  

Clinical Trials in Bipolar Mania: Implications in Study Design and Drug Development
Tohen
Arch Gen Psychiatry 2008;65:252-253.
FULL TEXT  

Executive Function and Employment Status Among Veterans With Bipolar Disorder
Altshuler et al.
Psychiatr. Serv. 2007;58:1441-1447.
ABSTRACT | FULL TEXT  

Psychosocial Treatments for Bipolar Depression: A 1-Year Randomized Trial From the Systematic Treatment Enhancement Program
Miklowitz et al.
Arch Gen Psychiatry 2007;64:419-426.
ABSTRACT | FULL TEXT  

Effects of Co-occurring Cannabis Use Disorders on the Course of Bipolar Disorder After a First Hospitalization for Mania
Strakowski et al.
Arch Gen Psychiatry 2007;64:57-64.
ABSTRACT | FULL TEXT  

Influence of sub-syndromal symptoms after remission from manic or mixed episodes
TOHEN et al.
Br. J. Psychiatry 2006;189:515-519.
ABSTRACT | FULL TEXT  

Predictors of Recurrence in Bipolar Disorder: Primary Outcomes From the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD)
Perlis et al.
Focus 2006;4:553.
FULL TEXT  

Olanzapine - relapse prevention following mania
Dando and Tohen
J Psychopharmacol 2006;20:31-38.
ABSTRACT  

Predictors of Recurrence in Bipolar Disorder: Primary Outcomes From the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD)
Perlis et al.
Am. J. Psychiatry 2006;163:217-224.
ABSTRACT | FULL TEXT  

Randomized, Placebo-Controlled Trial of Olanzapine as Maintenance Therapy in Patients With Bipolar I Disorder Responding to Acute Treatment With Olanzapine
Tohen et al.
Am. J. Psychiatry 2006;163:247-256.
ABSTRACT | FULL TEXT  

Adding cognitive therapy to minimal psychiatric care prevents short term, but not long term, relapse in people with bipolar disorder
Lau
Evid. Based Ment. Health 2005;8:102-102.
FULL TEXT  

Mixed Hypomania in 908 Patients With Bipolar Disorder Evaluated Prospectively in the Stanley Foundation Bipolar Treatment Network: A Sex-Specific Phenomenon
Suppes et al.
Arch Gen Psychiatry 2005;62:1089-1096.
ABSTRACT | FULL TEXT  

Two-Year Outcomes for Interpersonal and Social Rhythm Therapy in Individuals With Bipolar I Disorder
Frank et al.
Arch Gen Psychiatry 2005;62:996-1004.
ABSTRACT | FULL TEXT  

Effects of Co-occurring Alcohol Abuse on the Course of Bipolar Disorder Following a First Hospitalization for Mania
Strakowski et al.
Arch Gen Psychiatry 2005;62:851-858.
ABSTRACT | FULL TEXT  

Olanzapine Versus Lithium in the Maintenance Treatment of Bipolar Disorder: A 12-Month, Randomized, Double-Blind, Controlled Clinical Trial
Tohen et al.
Am. J. Psychiatry 2005;162:1281-1290.
ABSTRACT | FULL TEXT  

Diminished Suppression of the P50 Auditory Evoked Potential in Bipolar Disorder Subjects With a History of Psychosis
Olincy and Martin
Am. J. Psychiatry 2005;162:43-49.
ABSTRACT | FULL TEXT  

The early warning symptom intervention for patients with bipolar affective disorder
Morriss
Adv. Psychiatr. Treat. 2004;10:18-26.
ABSTRACT | FULL TEXT  

The McLean-Harvard First-Episode Mania Study: Prediction of Recovery and First Recurrence
Tohen et al.
Am. J. Psychiatry 2003;160:2099-2107.
ABSTRACT | FULL TEXT  

A Randomized Study of Family-Focused Psychoeducation and Pharmacotherapy in the Outpatient Management of Bipolar Disorder
Miklowitz et al.
Arch Gen Psychiatry 2003;60:904-912.
ABSTRACT | FULL TEXT  

Olanzapine Versus Divalproex Sodium for the Treatment of Acute Mania and Maintenance of Remission: A 47-Week Study
Tohen et al.
Am. J. Psychiatry 2003;160:1263-1271.
ABSTRACT | FULL TEXT  

Combining cognitive therapy with medication in bipolar disorder
Watkins
Adv. Psychiatr. Treat. 2003;9:110-116.
ABSTRACT | FULL TEXT  

12-Month Outcome of Patients With Bipolar Disorder Following Hospitalization for a Manic or Mixed Episode
Keck et al.
Focus 2003;1:44-52.
ABSTRACT | FULL TEXT  

Practice Guideline for the Treatment of Patients With Bipolar Disorder (Revision)
Hirschfeld et al.
Focus 2003;1:64-110.
FULL TEXT  

The Case of Sam: Multidisciplinary Perspectives: Psychiatric Medication: What Medications Should Be Prescribed?
Zarate
Psychiatr. Serv. 2001;52:1325-1328.
FULL TEXT  

Long-term clinical effectiveness of lithium maintenance treatment in types I and II bipolar disorders
TONDO et al.
Br. J. Psychiatry 2001;178 :s184-s190.
ABSTRACT | FULL TEXT  

A Randomized, Placebo-Controlled 12-Month Trial of Divalproex and Lithium in Treatment of Outpatients With Bipolar I Disorder
Bowden et al.
Arch Gen Psychiatry 2000;57:481-489.
ABSTRACT | FULL TEXT  

Maintenance Treatment in Bipolar Disorder
Baldessarini et al.
Arch Gen Psychiatry 2000;57:490-492.
FULL TEXT  

A Review of Bipolar Disorder Among Adults
Hilty et al.
Psychiatr. Serv. 1999;50:201-213.
ABSTRACT | FULL TEXT  

Randomised controlled trial of efficacy of teaching patients with bipolar disorder to identify early symptoms of relapse and obtain treatment
Perry et al.
BMJ 1999;318:149-153.
ABSTRACT | FULL TEXT  

12-Month Outcome of Patients With Bipolar Disorder Following Hospitalization for a Manic or Mixed Episode
Keck et al.
Am. J. Psychiatry 1998;155:646-652.
ABSTRACT | FULL TEXT  

Long-Term Outcome of Lithium Prophylaxis in Bipolar Disorder: A 5-Year Prospective Study of 402 Patients at a Lithium Clinic
Maj et al.
Am. J. Psychiatry 1998;155:30-35.
ABSTRACT | FULL TEXT  

Understanding Manic-depressive Illness
Goodwin and Ghaemi
Arch Gen Psychiatry 1998;55:23-25.
FULL TEXT  

Twelve-Month Outcome After a First Hospitalization for Affective Psychosis
Strakowski et al.
Arch Gen Psychiatry 1998;55:49-55.
ABSTRACT | FULL TEXT  

Unanswered Questions, Unknown Future for One of Our Oldest Medications
Gitlin and Altshuler
Arch Gen Psychiatry 1997;54:21-23.
ABSTRACT  

An 8-Year Follow-up of 450 Sons of Alcoholic and Control Subjects
Schuckit and Smith
Arch Gen Psychiatry 1996;53:202-210.
ABSTRACT  

A Reevaluation of Risk of In Utero Exposure to Lithium
Cohen et al.
JAMA 1994;271:146-150.
ABSTRACT  

Outcome After Rapid vs Gradual Discontinuation of Lithium Treatment in Bipolar Disorders
Faedda et al.
Arch Gen Psychiatry 1993;50:448-455.
ABSTRACT  

The effects of treatment on mortality in affective illness
Goodwin
J Psychopharmacol 1992;6:312-317.
ABSTRACT