A Naturalistic Study of Outcomes for Durable Remission in Patients With Bipolar Disorder

J Psychiatr Pract. 2021 Mar 5;27(2):86-91. doi: 10.1097/PRA.0000000000000530.

Abstract

Objective: Bipolar disorder is a severe mental illness affecting emotional stability, physical health, and quality of life. In a previous study, we identified medications associated with remission in patients with bipolar disorder. The objective of the current study was to determine the status of the patients after 3 additional years, as well as the medications associated with remission.

Methods: Data were extracted from clinical records. The criteria for remission in both the original study and the follow-up were 12 continuous months of euthymia, mild symptoms, and no clinical relapse. Active illness was defined as <12 months of remission. Statistical comparisons were made between the remitted and active illness groups on demographics and medication regimens.

Results: The original study contained 121 patients, 52 of whom were available for follow-up. Of the 121 patients from the original study, 53 (43.8%) were remitted for at least 12 months. Follow-up data were available for 19 of those patients, 15 of whom continued in remission while 4 relapsed. Of the 68 patients who were still ill at the end of the first study, follow-up data were available for 33 patients, 18 of whom had achieved remission at the time of follow-up while 15 continued to be ill. Remitted patients were more likely to be receiving a mood stabilizer (P=0.022) or a combination of a mood stabilizer and an antidepressant (P=0.004).

Conclusions: On the basis of our results, mood stabilizers and antidepressants were associated with remission in long-term follow-up. Remission may ultimately be possible for many patients who did not succeed initially.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Antidepressive Agents / therapeutic use
  • Antimanic Agents / therapeutic use
  • Bipolar Disorder / drug therapy*
  • Bipolar Disorder / psychology*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Quality of Life
  • Remission Induction
  • Treatment Outcome

Substances

  • Antidepressive Agents
  • Antimanic Agents