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One‐year rehospitalization rates of patients with first‐episode bipolar mania receiving lithium or valproate and adjunctive atypical antipsychotics
Author(s) -
Woo Young Sup,
Bahk WonMyong,
Jung YoungEun,
Jeong JongHyun,
Lee HwangBin,
Won SeungHee,
Lee Kwang Heun,
Jon DukIn,
Yoon BoHyun,
Kim MoonDoo,
Min Kyung Joon
Publication year - 2014
Publication title -
psychiatry and clinical neurosciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.609
H-Index - 74
eISSN - 1440-1819
pISSN - 1323-1316
DOI - 10.1111/pcn.12145
Subject(s) - quetiapine , bipolar disorder , lithium (medication) , risperidone , mania , atypical antipsychotic , olanzapine , medicine , antipsychotic , bipolar i disorder , treatment of bipolar disorder , mood stabilizer , psychiatry , psychology , schizophrenia (object oriented programming) , pediatrics
Aim We compared the 1‐year rehospitalization rates of first‐episode bipolar manic patients who were discharged while being treated with lithium or valproate in combination with an atypical antipsychotic. Methods We investigated the rehospitalization status of first‐episode bipolar manic patients who were discharged between 1 J anuary 2003 and 31 D ecember 2010 while they were taking lithium or valproate in combination with aripiprazole, olanzapine, quetiapine, or risperidone. Rehospitalization rates during a 1‐year period after discharge were compared between the group receiving lithium plus an atypical antipsychotic and the group receiving valproate plus an atypical antipsychotic using the K aplan– M eier method. A C ox regression model was used to analyze covariates hypothesized to affect time to rehospitalization. Results The rehospitalization rate was 17.3% during the 1‐year follow‐up period. We found significant differences in the rehospitalization rates of patients in the lithium (23.1%) and the valproate (13.3%) groups using the K aplan– M eier formula. According to C ox proportional hazards regression analysis, higher Clinical Global Impression–Bipolar Version–Severity score at discharge ( P = 0.005) and lithium treatment ( P = 0.055) contributed to the risk of rehospitalization. Conclusion Treatment with valproate and an atypical antipsychotic can be more effective than treatment with lithium and an atypical antipsychotic in preventing rehospitalization during the 1 year after hospitalization due to a first manic episode in patients with bipolar I disorder. Higher Clinical Global Impression–Bipolar Version–Severity scores at discharge also negatively affected rehospitalization rates.