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A Naturalistic Follow-up Study

Martin Harrow, PhD; Joseph F. Goldberg, MS; Linda S. Grossman, PhD; Herbert Y. Meltzer, MD

Arch Gen Psychiatry. 1990;47(7):665-671.

Abstract
• To study outcome in manic patients treated under routine clinical conditions, 73 manic and 66 unipolar depressed patients were followed up 1.7 years after hospitalization. A surprisingly large percentage of manic patients showed difficulty in post-hospital adjustment, and over 40% experienced a manic syndrome during the follow-up period. Manic patients showed poorer outcomes than did unipolar depressives. Manic patients taking lithium carbonate did not show better outcome than those not taking lithium carbonate. The results suggest (1) many hospitalized manic patients have a severe, recurrent, and pernicious disorder; and (2) in routine clinical practice, lithium carbonate treatment is an effective prophylaxis for fewer than the 70% to 80% of manic patients previously reported.

Author Affiliations
From the Department of Psychiatry, Michael Reese Hospital and Medical Center (Dr Harrow and Mr Goldberg), the Department of Psychiatry, University of Illinois College of Medicine (Dr Harrow), Committee on Human Development and Department of Psychology, University of Chicago (Dr Harrow), Northwestern University Medical School (Mr Goldberg), Departments of Psychiatry and Psychology and Social Sciences, Rush University, and Isaac Ray Center, Section on Psychiatry and the Law, Rush-Presbyterian—St Luke's Medical Center (Dr Grossman), Chicago, Ill; and Department of Psychiatry, Case Western Reserve University, Cleveland, Ohio (Dr Meltzer).

Footnotes
Accepted for publication June 30, 1989.

Read in part before the 139th Annual Meeting of the American Psychiatric Association, Washington, DC, May 15, 1986.

Reprint requests to Department of Psychiatry, Michael Reese Hospital and Medical Center, Lake Shore Dr at 31st St, Chicago, IL 60616 (Dr Harrow).

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