 |
|
Complicated ManiaComorbidity and Immediate Outcome in the Treatment of Mania
Donald W. Black, MD;
George Winokur, MD;
Sue Bell, MA;
Amelia Nasrallah, MA;
James Hulbert, PhD
Arch Gen Psychiatry. 1988;45(3):232-236.
Abstract
• In a case-control study, 57 manics with antecedent or coexisting nonaffective psychiatric disorders (n = 38) or serious medical illnesses (n = 19) ("complicated mania") were compared with 114 age-, sex-, and year-of-admisson—matched controls with no other disorder ("uncomplicated mania"). Significant differences emerged between the three groups in age, marital status, age at onset, number of prior hospitalizations and prior suicide attempts, organic features, and outcome measures (recovery and death rates). Patients were divided into four treatment groups based on primary mode of therapy during index admission; the groups included electroconvulsive therapy, adequate lithium carbonate, inadequate lithium carbonate, and neither treatment. Uncomplicated manics were significantly more likely to receive adequate lithium carbonate and less likely to receive inadequate lithium carbonate than were complicated manics. The latter patients had a significantly poorer immediate response to treatment overall, and to adequate lithium carbonate specifically. Seventy-eight (68.4%) uncomplicated manics had recovered at discharge, compared with 26 (45.6%) complicated manics. Logistic regression suggested that the influence of comorbidity on outcome was more important for women than men. We conclude that complicated mania is a useful clinical construct.
Author Affiliations
From the Department of Psychiatry, University of Iowa College of Medicine, Iowa City.
Footnotes
Accepted for publication Oct 16, 1987.
Reprint requests to Psychiatric Hospital, 500 Newton Rd, Iowa City, IA 52242 (Dr Black).
 CiteULike  Connotea  Delicious  Digg  Facebook  Reddit  Technorati  Twitter
What's this?
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
Carbamazepine Compared With Lithium in the Treatment of Mania
Small et al.
Arch Gen Psychiatry 1991;48:915-921.
ABSTRACT
|
