A 12-month prospective study on the time to hospitalization and clinical management of a cohort of bipolar type I and schizoaffective bipolar patients.
Identifieur interne : 000695 ( Main/Exploration ); précédent : 000694; suivant : 000696A 12-month prospective study on the time to hospitalization and clinical management of a cohort of bipolar type I and schizoaffective bipolar patients.
Auteurs : Andrea Murru [Espagne] ; Norma Verdolini [Espagne] ; Gerard Anmella [Espagne] ; Isabella Pacchiarotti [Espagne] ; Ludovic Samalin [France] ; Alberto Aedo [Chili] ; Juan Undurraga [Chili] ; José M. Goikolea [Espagne] ; Benedikt L. Amann [Espagne] ; Andre F. Carvalho [Canada] ; Eduard Vieta [Espagne]Source :
- European psychiatry : the journal of the Association of European Psychiatrists [ 1778-3585 ] ; 2019.
Descripteurs français
- KwdFr :
- Adulte (MeSH), Adulte d'âge moyen (MeSH), Agressivité (psychologie), Femelle (MeSH), Hospitalisation (statistiques et données numériques), Humains (MeSH), Mâle (MeSH), Récidive (MeSH), Tentative de suicide (psychologie), Trouble bipolaire (psychologie), Trouble bipolaire (thérapie), Troubles psychotiques (psychologie), Troubles psychotiques (thérapie), Études de cohortes (MeSH), Études prospectives (MeSH).
- MESH :
- psychologie : Agressivité, Tentative de suicide, Trouble bipolaire, Troubles psychotiques.
- statistiques et données numériques : Hospitalisation.
- thérapie : Trouble bipolaire, Troubles psychotiques.
- Adulte, Adulte d'âge moyen, Femelle, Humains, Mâle, Récidive, Études de cohortes, Études prospectives.
English descriptors
- KwdEn :
- Adult (MeSH), Aggression (psychology), Bipolar Disorder (psychology), Bipolar Disorder (therapy), Cohort Studies (MeSH), Female (MeSH), Hospitalization (statistics & numerical data), Humans (MeSH), Male (MeSH), Middle Aged (MeSH), Prospective Studies (MeSH), Psychotic Disorders (psychology), Psychotic Disorders (therapy), Recurrence (MeSH), Suicide, Attempted (psychology).
- MESH :
- psychology : Aggression, Bipolar Disorder, Psychotic Disorders, Suicide, Attempted.
- statistics & numerical data : Hospitalization.
- therapy : Bipolar Disorder, Psychotic Disorders.
- Adult, Cohort Studies, Female, Humans, Male, Middle Aged, Prospective Studies, Recurrence.
Abstract
BACKGROUND
Schizoaffective disorder, bipolar type (SAD) and bipolar disorder I (BD) present a large clinical overlap. In a 1-year follow-up, we aimed to evaluate days to hospitalization (DTH) and predictors of relapse in a SAD-BD cohort of patients.
METHODS
A 1-year, prospective, naturalistic cohort study considering DTH as primary outcome and incidence of direct and indirect measures of psychopathological compensation as secondary outcomes. Kaplan-Meyer survival analysis with Log-rank Mantel-Cox test compared BD/SAD subgroups as to DTH. After bivariate analyses, Cox regression was performed to assess covariates possibly associated with DTH in diagnostic subgroups.
RESULTS
Of 836 screened patients, 437 were finally included (SAD = 105; BD = 332). Relapse rates in the SAD sample was n = 26 (24.8%) vs. n = 41 (12.3%) in the BD sample (p = 0.002). Mean ± SD DTH were 312.16 ± 10.6 (SAD) vs. 337.62 ± 4.4 (BD) days (p = 0.002). Patients with relapses showed more frequent suicide acts, violent behaviors, and changes in pharmacological treatments (all p < 0.0005) in comparison to patients without relapse. Patients without relapses had significantly higher mean number of treatments at T0 (p = 0.010). Cox regression model relating the association between diagnosis and DTH revealed that BD had higher rates of suicide attempts (HR = 13.0, 95%CI = 4.0-42.0, p < 0.0005), whereas SAD had higher rates of violent behavior during psychotic episodes (HR = 12.0, 95%CI = .3.3-43.5, p > 0.0005).
CONCLUSIONS
SAD patients relapse earlier with higher hospitalization rates and violent behavior during psychotic episodes whereas bipolar patients have more suicide attempts. Psychiatric/psychological follow-up visits may delay hospitalizations by closely monitoring symptoms of self- and hetero-aggression.
DOI: 10.1016/j.eurpsy.2019.06.001
PubMed: 31255957
Affiliations:
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">A 12-month prospective study on the time to hospitalization and clinical management of a cohort of bipolar type I and schizoaffective bipolar patients.</title><author><name sortKey="Murru, Andrea" sort="Murru, Andrea" uniqKey="Murru A" first="Andrea" last="Murru">Andrea Murru</name><affiliation wicri:level="1"><nlm:affiliation>Bipolar Disorders Unit, Institute of Neuroscience, Hospital Clínic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Bipolar Disorders Unit, Institute of Neuroscience, Hospital Clínic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia</wicri:regionArea><wicri:noRegion>Catalonia</wicri:noRegion></affiliation></author><author><name sortKey="Verdolini, Norma" sort="Verdolini, Norma" uniqKey="Verdolini N" first="Norma" last="Verdolini">Norma Verdolini</name><affiliation wicri:level="1"><nlm:affiliation>Bipolar Disorders Unit, Institute of Neuroscience, Hospital Clínic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain; Division of Psychiatry, Clinical Psychology and Rehabilitation, University of Perugia, Perugia, Italy; FIDMAG Germanes Hospitalàries Research Foundation, Sant Boi de Llobregat, Barcelona, Catalonia, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Bipolar Disorders Unit, Institute of Neuroscience, Hospital Clínic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain; Division of Psychiatry, Clinical Psychology and Rehabilitation, University of Perugia, Perugia, Italy; FIDMAG Germanes Hospitalàries Research Foundation, Sant Boi de Llobregat, Barcelona, Catalonia</wicri:regionArea><wicri:noRegion>Catalonia</wicri:noRegion></affiliation></author><author><name sortKey="Anmella, Gerard" sort="Anmella, Gerard" uniqKey="Anmella G" first="Gerard" last="Anmella">Gerard Anmella</name><affiliation wicri:level="1"><nlm:affiliation>Bipolar Disorders Unit, Institute of Neuroscience, Hospital Clínic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Bipolar Disorders Unit, Institute of Neuroscience, Hospital Clínic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia</wicri:regionArea><wicri:noRegion>Catalonia</wicri:noRegion></affiliation></author><author><name sortKey="Pacchiarotti, Isabella" sort="Pacchiarotti, Isabella" uniqKey="Pacchiarotti I" first="Isabella" last="Pacchiarotti">Isabella Pacchiarotti</name><affiliation wicri:level="1"><nlm:affiliation>Bipolar Disorders Unit, Institute of Neuroscience, Hospital Clínic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Bipolar Disorders Unit, Institute of Neuroscience, Hospital Clínic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia</wicri:regionArea><wicri:noRegion>Catalonia</wicri:noRegion></affiliation></author><author><name sortKey="Samalin, Ludovic" sort="Samalin, Ludovic" uniqKey="Samalin L" first="Ludovic" last="Samalin">Ludovic Samalin</name><affiliation wicri:level="3"><nlm:affiliation>EA 7280, Department of Psychiatry, CHU Clermont-Ferrand, University of Auvergne, 58, rue Montalembert, 63000, Clermont-Ferrand, France; Pôle de psychiatrie, Fondation FondaMental, Hôpital Albert-Chenevier, 40, rue de Mesly, 94000, Créteil, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>EA 7280, Department of Psychiatry, CHU Clermont-Ferrand, University of Auvergne, 58, rue Montalembert, 63000, Clermont-Ferrand, France; Pôle de psychiatrie, Fondation FondaMental, Hôpital Albert-Chenevier, 40, rue de Mesly, 94000, Créteil</wicri:regionArea><placeName><region type="region" nuts="2">Île-de-France</region><settlement type="city">Créteil</settlement></placeName></affiliation></author><author><name sortKey="Aedo, Alberto" sort="Aedo, Alberto" uniqKey="Aedo A" first="Alberto" last="Aedo">Alberto Aedo</name><affiliation wicri:level="1"><nlm:affiliation>Bipolar Disorders Unit, Institute of Neuroscience, Hospital Clínic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain; Unidad de Trastorno Afectivo Bipolar, Departamento de Psiquiatría, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.</nlm:affiliation><country xml:lang="fr">Chili</country><wicri:regionArea>Bipolar Disorders Unit, Institute of Neuroscience, Hospital Clínic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain; Unidad de Trastorno Afectivo Bipolar, Departamento de Psiquiatría, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago</wicri:regionArea><wicri:noRegion>Santiago</wicri:noRegion></affiliation></author><author><name sortKey="Undurraga, Juan" sort="Undurraga, Juan" uniqKey="Undurraga J" first="Juan" last="Undurraga">Juan Undurraga</name><affiliation wicri:level="1"><nlm:affiliation>Department of Psychiatry, Faculty of Medicine, Clínica Alemana Universidad del Desarrollo, Santiago, Chile; Early Intervention Program, J. Horwitz Psychiatric Institute, Santiago, Chile.</nlm:affiliation><country xml:lang="fr">Chili</country><wicri:regionArea>Department of Psychiatry, Faculty of Medicine, Clínica Alemana Universidad del Desarrollo, Santiago, Chile; Early Intervention Program, J. Horwitz Psychiatric Institute, Santiago</wicri:regionArea><wicri:noRegion>Santiago</wicri:noRegion></affiliation></author><author><name sortKey="Goikolea, Jose M" sort="Goikolea, Jose M" uniqKey="Goikolea J" first="José M" last="Goikolea">José M. Goikolea</name><affiliation wicri:level="1"><nlm:affiliation>Bipolar Disorders Unit, Institute of Neuroscience, Hospital Clínic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Bipolar Disorders Unit, Institute of Neuroscience, Hospital Clínic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia</wicri:regionArea><wicri:noRegion>Catalonia</wicri:noRegion></affiliation></author><author><name sortKey="Amann, Benedikt L" sort="Amann, Benedikt L" uniqKey="Amann B" first="Benedikt L" last="Amann">Benedikt L. Amann</name><affiliation wicri:level="1"><nlm:affiliation>Institut de Neuropsiquiatria i Addiccions, Hospital del Mar, Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Research Unit Centro Fórum, CIBERSAM, Department of Psychiatry, Autonomous University Barcelona, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Institut de Neuropsiquiatria i Addiccions, Hospital del Mar, Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Research Unit Centro Fórum, CIBERSAM, Department of Psychiatry, Autonomous University Barcelona</wicri:regionArea><wicri:noRegion>Autonomous University Barcelona</wicri:noRegion></affiliation></author><author><name sortKey="Carvalho, Andre F" sort="Carvalho, Andre F" uniqKey="Carvalho A" first="Andre F" last="Carvalho">Andre F. Carvalho</name><affiliation wicri:level="4"><nlm:affiliation>Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada; Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada.</nlm:affiliation><country xml:lang="fr">Canada</country><wicri:regionArea>Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada; Centre for Addiction and Mental Health (CAMH), Toronto, ON</wicri:regionArea><orgName type="university">Université de Toronto</orgName><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName></affiliation></author><author><name sortKey="Vieta, Eduard" sort="Vieta, Eduard" uniqKey="Vieta E" first="Eduard" last="Vieta">Eduard Vieta</name><affiliation wicri:level="1"><nlm:affiliation>Bipolar Disorders Unit, Institute of Neuroscience, Hospital Clínic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain. Electronic address: EVIETA@clinic.cat.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Bipolar Disorders Unit, Institute of Neuroscience, Hospital Clínic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia</wicri:regionArea><wicri:noRegion>Catalonia</wicri:noRegion></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2019">2019</date><idno type="RBID">pubmed:31255957</idno><idno type="pmid">31255957</idno><idno type="doi">10.1016/j.eurpsy.2019.06.001</idno><idno type="wicri:Area/Main/Corpus">000437</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Corpus" wicri:corpus="PubMed">000437</idno><idno type="wicri:Area/Main/Curation">000437</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Curation">000437</idno><idno type="wicri:Area/Main/Exploration">000437</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">A 12-month prospective study on the time to hospitalization and clinical management of a cohort of bipolar type I and schizoaffective bipolar patients.</title><author><name sortKey="Murru, Andrea" sort="Murru, Andrea" uniqKey="Murru A" first="Andrea" last="Murru">Andrea Murru</name><affiliation wicri:level="1"><nlm:affiliation>Bipolar Disorders Unit, Institute of Neuroscience, Hospital Clínic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Bipolar Disorders Unit, Institute of Neuroscience, Hospital Clínic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia</wicri:regionArea><wicri:noRegion>Catalonia</wicri:noRegion></affiliation></author><author><name sortKey="Verdolini, Norma" sort="Verdolini, Norma" uniqKey="Verdolini N" first="Norma" last="Verdolini">Norma Verdolini</name><affiliation wicri:level="1"><nlm:affiliation>Bipolar Disorders Unit, Institute of Neuroscience, Hospital Clínic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain; Division of Psychiatry, Clinical Psychology and Rehabilitation, University of Perugia, Perugia, Italy; FIDMAG Germanes Hospitalàries Research Foundation, Sant Boi de Llobregat, Barcelona, Catalonia, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Bipolar Disorders Unit, Institute of Neuroscience, Hospital Clínic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain; Division of Psychiatry, Clinical Psychology and Rehabilitation, University of Perugia, Perugia, Italy; FIDMAG Germanes Hospitalàries Research Foundation, Sant Boi de Llobregat, Barcelona, Catalonia</wicri:regionArea><wicri:noRegion>Catalonia</wicri:noRegion></affiliation></author><author><name sortKey="Anmella, Gerard" sort="Anmella, Gerard" uniqKey="Anmella G" first="Gerard" last="Anmella">Gerard Anmella</name><affiliation wicri:level="1"><nlm:affiliation>Bipolar Disorders Unit, Institute of Neuroscience, Hospital Clínic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Bipolar Disorders Unit, Institute of Neuroscience, Hospital Clínic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia</wicri:regionArea><wicri:noRegion>Catalonia</wicri:noRegion></affiliation></author><author><name sortKey="Pacchiarotti, Isabella" sort="Pacchiarotti, Isabella" uniqKey="Pacchiarotti I" first="Isabella" last="Pacchiarotti">Isabella Pacchiarotti</name><affiliation wicri:level="1"><nlm:affiliation>Bipolar Disorders Unit, Institute of Neuroscience, Hospital Clínic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Bipolar Disorders Unit, Institute of Neuroscience, Hospital Clínic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia</wicri:regionArea><wicri:noRegion>Catalonia</wicri:noRegion></affiliation></author><author><name sortKey="Samalin, Ludovic" sort="Samalin, Ludovic" uniqKey="Samalin L" first="Ludovic" last="Samalin">Ludovic Samalin</name><affiliation wicri:level="3"><nlm:affiliation>EA 7280, Department of Psychiatry, CHU Clermont-Ferrand, University of Auvergne, 58, rue Montalembert, 63000, Clermont-Ferrand, France; Pôle de psychiatrie, Fondation FondaMental, Hôpital Albert-Chenevier, 40, rue de Mesly, 94000, Créteil, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>EA 7280, Department of Psychiatry, CHU Clermont-Ferrand, University of Auvergne, 58, rue Montalembert, 63000, Clermont-Ferrand, France; Pôle de psychiatrie, Fondation FondaMental, Hôpital Albert-Chenevier, 40, rue de Mesly, 94000, Créteil</wicri:regionArea><placeName><region type="region" nuts="2">Île-de-France</region><settlement type="city">Créteil</settlement></placeName></affiliation></author><author><name sortKey="Aedo, Alberto" sort="Aedo, Alberto" uniqKey="Aedo A" first="Alberto" last="Aedo">Alberto Aedo</name><affiliation wicri:level="1"><nlm:affiliation>Bipolar Disorders Unit, Institute of Neuroscience, Hospital Clínic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain; Unidad de Trastorno Afectivo Bipolar, Departamento de Psiquiatría, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.</nlm:affiliation><country xml:lang="fr">Chili</country><wicri:regionArea>Bipolar Disorders Unit, Institute of Neuroscience, Hospital Clínic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain; Unidad de Trastorno Afectivo Bipolar, Departamento de Psiquiatría, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago</wicri:regionArea><wicri:noRegion>Santiago</wicri:noRegion></affiliation></author><author><name sortKey="Undurraga, Juan" sort="Undurraga, Juan" uniqKey="Undurraga J" first="Juan" last="Undurraga">Juan Undurraga</name><affiliation wicri:level="1"><nlm:affiliation>Department of Psychiatry, Faculty of Medicine, Clínica Alemana Universidad del Desarrollo, Santiago, Chile; Early Intervention Program, J. Horwitz Psychiatric Institute, Santiago, Chile.</nlm:affiliation><country xml:lang="fr">Chili</country><wicri:regionArea>Department of Psychiatry, Faculty of Medicine, Clínica Alemana Universidad del Desarrollo, Santiago, Chile; Early Intervention Program, J. Horwitz Psychiatric Institute, Santiago</wicri:regionArea><wicri:noRegion>Santiago</wicri:noRegion></affiliation></author><author><name sortKey="Goikolea, Jose M" sort="Goikolea, Jose M" uniqKey="Goikolea J" first="José M" last="Goikolea">José M. Goikolea</name><affiliation wicri:level="1"><nlm:affiliation>Bipolar Disorders Unit, Institute of Neuroscience, Hospital Clínic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Bipolar Disorders Unit, Institute of Neuroscience, Hospital Clínic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia</wicri:regionArea><wicri:noRegion>Catalonia</wicri:noRegion></affiliation></author><author><name sortKey="Amann, Benedikt L" sort="Amann, Benedikt L" uniqKey="Amann B" first="Benedikt L" last="Amann">Benedikt L. Amann</name><affiliation wicri:level="1"><nlm:affiliation>Institut de Neuropsiquiatria i Addiccions, Hospital del Mar, Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Research Unit Centro Fórum, CIBERSAM, Department of Psychiatry, Autonomous University Barcelona, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Institut de Neuropsiquiatria i Addiccions, Hospital del Mar, Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Research Unit Centro Fórum, CIBERSAM, Department of Psychiatry, Autonomous University Barcelona</wicri:regionArea><wicri:noRegion>Autonomous University Barcelona</wicri:noRegion></affiliation></author><author><name sortKey="Carvalho, Andre F" sort="Carvalho, Andre F" uniqKey="Carvalho A" first="Andre F" last="Carvalho">Andre F. Carvalho</name><affiliation wicri:level="4"><nlm:affiliation>Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada; Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada.</nlm:affiliation><country xml:lang="fr">Canada</country><wicri:regionArea>Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada; Centre for Addiction and Mental Health (CAMH), Toronto, ON</wicri:regionArea><orgName type="university">Université de Toronto</orgName><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName></affiliation></author><author><name sortKey="Vieta, Eduard" sort="Vieta, Eduard" uniqKey="Vieta E" first="Eduard" last="Vieta">Eduard Vieta</name><affiliation wicri:level="1"><nlm:affiliation>Bipolar Disorders Unit, Institute of Neuroscience, Hospital Clínic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain. Electronic address: EVIETA@clinic.cat.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Bipolar Disorders Unit, Institute of Neuroscience, Hospital Clínic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia</wicri:regionArea><wicri:noRegion>Catalonia</wicri:noRegion></affiliation></author></analytic><series><title level="j">European psychiatry : the journal of the Association of European Psychiatrists</title><idno type="eISSN">1778-3585</idno><imprint><date when="2019" type="published">2019</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult (MeSH)</term><term>Aggression (psychology)</term><term>Bipolar Disorder (psychology)</term><term>Bipolar Disorder (therapy)</term><term>Cohort Studies (MeSH)</term><term>Female (MeSH)</term><term>Hospitalization (statistics & numerical data)</term><term>Humans (MeSH)</term><term>Male (MeSH)</term><term>Middle Aged (MeSH)</term><term>Prospective Studies (MeSH)</term><term>Psychotic Disorders (psychology)</term><term>Psychotic Disorders (therapy)</term><term>Recurrence (MeSH)</term><term>Suicide, Attempted (psychology)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adulte (MeSH)</term><term>Adulte d'âge moyen (MeSH)</term><term>Agressivité (psychologie)</term><term>Femelle (MeSH)</term><term>Hospitalisation (statistiques et données numériques)</term><term>Humains (MeSH)</term><term>Mâle (MeSH)</term><term>Récidive (MeSH)</term><term>Tentative de suicide (psychologie)</term><term>Trouble bipolaire (psychologie)</term><term>Trouble bipolaire (thérapie)</term><term>Troubles psychotiques (psychologie)</term><term>Troubles psychotiques (thérapie)</term><term>Études de cohortes (MeSH)</term><term>Études prospectives (MeSH)</term></keywords><keywords scheme="MESH" qualifier="psychologie" xml:lang="fr"><term>Agressivité</term><term>Tentative de suicide</term><term>Trouble bipolaire</term><term>Troubles psychotiques</term></keywords><keywords scheme="MESH" qualifier="psychology" xml:lang="en"><term>Aggression</term><term>Bipolar Disorder</term><term>Psychotic Disorders</term><term>Suicide, Attempted</term></keywords><keywords scheme="MESH" qualifier="statistics & numerical data" xml:lang="en"><term>Hospitalization</term></keywords><keywords scheme="MESH" qualifier="statistiques et données numériques" xml:lang="fr"><term>Hospitalisation</term></keywords><keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Bipolar Disorder</term><term>Psychotic Disorders</term></keywords><keywords scheme="MESH" qualifier="thérapie" xml:lang="fr"><term>Trouble bipolaire</term><term>Troubles psychotiques</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adult</term><term>Cohort Studies</term><term>Female</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Prospective Studies</term><term>Recurrence</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adulte</term><term>Adulte d'âge moyen</term><term>Femelle</term><term>Humains</term><term>Mâle</term><term>Récidive</term><term>Études de cohortes</term><term>Études prospectives</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>BACKGROUND</b></p><p>Schizoaffective disorder, bipolar type (SAD) and bipolar disorder I (BD) present a large clinical overlap. In a 1-year follow-up, we aimed to evaluate days to hospitalization (DTH) and predictors of relapse in a SAD-BD cohort of patients.</p></div><div type="abstract" xml:lang="en"><p><b>METHODS</b></p><p>A 1-year, prospective, naturalistic cohort study considering DTH as primary outcome and incidence of direct and indirect measures of psychopathological compensation as secondary outcomes. Kaplan-Meyer survival analysis with Log-rank Mantel-Cox test compared BD/SAD subgroups as to DTH. After bivariate analyses, Cox regression was performed to assess covariates possibly associated with DTH in diagnostic subgroups.</p></div><div type="abstract" xml:lang="en"><p><b>RESULTS</b></p><p>Of 836 screened patients, 437 were finally included (SAD = 105; BD = 332). Relapse rates in the SAD sample was n = 26 (24.8%) vs. n = 41 (12.3%) in the BD sample (p = 0.002). Mean ± SD DTH were 312.16 ± 10.6 (SAD) vs. 337.62 ± 4.4 (BD) days (p = 0.002). Patients with relapses showed more frequent suicide acts, violent behaviors, and changes in pharmacological treatments (all p < 0.0005) in comparison to patients without relapse. Patients without relapses had significantly higher mean number of treatments at T0 (p = 0.010). Cox regression model relating the association between diagnosis and DTH revealed that BD had higher rates of suicide attempts (HR = 13.0, 95%CI = 4.0-42.0, p < 0.0005), whereas SAD had higher rates of violent behavior during psychotic episodes (HR = 12.0, 95%CI = .3.3-43.5, p > 0.0005).</p></div><div type="abstract" xml:lang="en"><p><b>CONCLUSIONS</b></p><p>SAD patients relapse earlier with higher hospitalization rates and violent behavior during psychotic episodes whereas bipolar patients have more suicide attempts. Psychiatric/psychological follow-up visits may delay hospitalizations by closely monitoring symptoms of self- and hetero-aggression.</p></div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" IndexingMethod="Curated" Owner="NLM"><PMID Version="1">31255957</PMID><DateCompleted><Year>2020</Year><Month>07</Month><Day>21</Day></DateCompleted><DateRevised><Year>2020</Year><Month>07</Month><Day>21</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1778-3585</ISSN><JournalIssue CitedMedium="Internet"><Volume>61</Volume><PubDate><Year>2019</Year><Month>09</Month></PubDate></JournalIssue><Title>European psychiatry : the journal of the Association of European Psychiatrists</Title><ISOAbbreviation>Eur Psychiatry</ISOAbbreviation></Journal><ArticleTitle>A 12-month prospective study on the time to hospitalization and clinical management of a cohort of bipolar type I and schizoaffective bipolar patients.</ArticleTitle><Pagination><MedlinePgn>1-8</MedlinePgn></Pagination><ELocationID EIdType="pii" ValidYN="Y">S0924-9338(19)30099-9</ELocationID><ELocationID EIdType="doi" ValidYN="Y">10.1016/j.eurpsy.2019.06.001</ELocationID><Abstract><AbstractText Label="BACKGROUND">Schizoaffective disorder, bipolar type (SAD) and bipolar disorder I (BD) present a large clinical overlap. In a 1-year follow-up, we aimed to evaluate days to hospitalization (DTH) and predictors of relapse in a SAD-BD cohort of patients.</AbstractText><AbstractText Label="METHODS">A 1-year, prospective, naturalistic cohort study considering DTH as primary outcome and incidence of direct and indirect measures of psychopathological compensation as secondary outcomes. Kaplan-Meyer survival analysis with Log-rank Mantel-Cox test compared BD/SAD subgroups as to DTH. After bivariate analyses, Cox regression was performed to assess covariates possibly associated with DTH in diagnostic subgroups.</AbstractText><AbstractText Label="RESULTS">Of 836 screened patients, 437 were finally included (SAD = 105; BD = 332). Relapse rates in the SAD sample was n = 26 (24.8%) vs. n = 41 (12.3%) in the BD sample (p = 0.002). Mean ± SD DTH were 312.16 ± 10.6 (SAD) vs. 337.62 ± 4.4 (BD) days (p = 0.002). Patients with relapses showed more frequent suicide acts, violent behaviors, and changes in pharmacological treatments (all p < 0.0005) in comparison to patients without relapse. Patients without relapses had significantly higher mean number of treatments at T0 (p = 0.010). Cox regression model relating the association between diagnosis and DTH revealed that BD had higher rates of suicide attempts (HR = 13.0, 95%CI = 4.0-42.0, p < 0.0005), whereas SAD had higher rates of violent behavior during psychotic episodes (HR = 12.0, 95%CI = .3.3-43.5, p > 0.0005).</AbstractText><AbstractText Label="CONCLUSIONS">SAD patients relapse earlier with higher hospitalization rates and violent behavior during psychotic episodes whereas bipolar patients have more suicide attempts. Psychiatric/psychological follow-up visits may delay hospitalizations by closely monitoring symptoms of self- and hetero-aggression.</AbstractText><CopyrightInformation>Copyright © 2019. Published by Elsevier Masson SAS.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Murru</LastName><ForeName>Andrea</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Bipolar Disorders Unit, Institute of Neuroscience, Hospital Clínic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Verdolini</LastName><ForeName>Norma</ForeName><Initials>N</Initials><AffiliationInfo><Affiliation>Bipolar Disorders Unit, Institute of Neuroscience, Hospital Clínic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain; Division of Psychiatry, Clinical Psychology and Rehabilitation, University of Perugia, Perugia, Italy; FIDMAG Germanes Hospitalàries Research Foundation, Sant Boi de Llobregat, Barcelona, Catalonia, Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Anmella</LastName><ForeName>Gerard</ForeName><Initials>G</Initials><AffiliationInfo><Affiliation>Bipolar Disorders Unit, Institute of Neuroscience, Hospital Clínic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Pacchiarotti</LastName><ForeName>Isabella</ForeName><Initials>I</Initials><AffiliationInfo><Affiliation>Bipolar Disorders Unit, Institute of Neuroscience, Hospital Clínic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Samalin</LastName><ForeName>Ludovic</ForeName><Initials>L</Initials><AffiliationInfo><Affiliation>EA 7280, Department of Psychiatry, CHU Clermont-Ferrand, University of Auvergne, 58, rue Montalembert, 63000, Clermont-Ferrand, France; Pôle de psychiatrie, Fondation FondaMental, Hôpital Albert-Chenevier, 40, rue de Mesly, 94000, Créteil, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Aedo</LastName><ForeName>Alberto</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Bipolar Disorders Unit, Institute of Neuroscience, Hospital Clínic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain; Unidad de Trastorno Afectivo Bipolar, Departamento de Psiquiatría, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Undurraga</LastName><ForeName>Juan</ForeName><Initials>J</Initials><AffiliationInfo><Affiliation>Department of Psychiatry, Faculty of Medicine, Clínica Alemana Universidad del Desarrollo, Santiago, Chile; Early Intervention Program, J. Horwitz Psychiatric Institute, Santiago, Chile.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Goikolea</LastName><ForeName>José M</ForeName><Initials>JM</Initials><AffiliationInfo><Affiliation>Bipolar Disorders Unit, Institute of Neuroscience, Hospital Clínic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Amann</LastName><ForeName>Benedikt L</ForeName><Initials>BL</Initials><AffiliationInfo><Affiliation>Institut de Neuropsiquiatria i Addiccions, Hospital del Mar, Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Research Unit Centro Fórum, CIBERSAM, Department of Psychiatry, Autonomous University Barcelona, Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Carvalho</LastName><ForeName>Andre F</ForeName><Initials>AF</Initials><AffiliationInfo><Affiliation>Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada; Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Vieta</LastName><ForeName>Eduard</ForeName><Initials>E</Initials><AffiliationInfo><Affiliation>Bipolar Disorders Unit, Institute of Neuroscience, Hospital Clínic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain. Electronic address: EVIETA@clinic.cat.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D013485">Research Support, Non-U.S. Gov't</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2019</Year><Month>06</Month><Day>28</Day></ArticleDate></Article><MedlineJournalInfo><Country>England</Country><MedlineTA>Eur Psychiatry</MedlineTA><NlmUniqueID>9111820</NlmUniqueID><ISSNLinking>0924-9338</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000328" MajorTopicYN="N">Adult</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000374" MajorTopicYN="N">Aggression</DescriptorName><QualifierName UI="Q000523" MajorTopicYN="Y">psychology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D001714" MajorTopicYN="N">Bipolar Disorder</DescriptorName><QualifierName UI="Q000523" MajorTopicYN="N">psychology</QualifierName><QualifierName UI="Q000628" MajorTopicYN="Y">therapy</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D015331" MajorTopicYN="N">Cohort Studies</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006760" MajorTopicYN="N">Hospitalization</DescriptorName><QualifierName UI="Q000706" MajorTopicYN="Y">statistics & numerical data</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D011446" MajorTopicYN="N">Prospective Studies</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D011618" MajorTopicYN="N">Psychotic Disorders</DescriptorName><QualifierName UI="Q000523" MajorTopicYN="N">psychology</QualifierName><QualifierName UI="Q000628" MajorTopicYN="Y">therapy</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D012008" MajorTopicYN="N">Recurrence</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D013406" MajorTopicYN="N">Suicide, Attempted</DescriptorName><QualifierName UI="Q000523" MajorTopicYN="N">psychology</QualifierName></MeshHeading></MeshHeadingList><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="Y">Aggressiveness</Keyword><Keyword MajorTopicYN="Y">Bipolar disorder</Keyword><Keyword MajorTopicYN="Y">Longitudinal study</Keyword><Keyword MajorTopicYN="Y">Schizoaffective disorder</Keyword><Keyword MajorTopicYN="Y">Suicide</Keyword></KeywordList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2018</Year><Month>10</Month><Day>30</Day></PubMedPubDate><PubMedPubDate PubStatus="revised"><Year>2019</Year><Month>05</Month><Day>15</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2019</Year><Month>06</Month><Day>06</Day></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2019</Year><Month>7</Month><Day>1</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2020</Year><Month>7</Month><Day>22</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2019</Year><Month>7</Month><Day>1</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">31255957</ArticleId><ArticleId IdType="pii">S0924-9338(19)30099-9</ArticleId><ArticleId IdType="doi">10.1016/j.eurpsy.2019.06.001</ArticleId></ArticleIdList></PubmedData></pubmed><affiliations><list><country><li>Canada</li><li>Chili</li><li>Espagne</li><li>France</li></country><region><li>Ontario</li><li>Île-de-France</li></region><settlement><li>Créteil</li><li>Toronto</li></settlement><orgName><li>Université de Toronto</li></orgName></list><tree><country name="Espagne"><noRegion><name sortKey="Murru, Andrea" sort="Murru, Andrea" uniqKey="Murru A" first="Andrea" last="Murru">Andrea Murru</name></noRegion><name sortKey="Amann, Benedikt L" sort="Amann, Benedikt L" uniqKey="Amann B" first="Benedikt L" last="Amann">Benedikt L. Amann</name><name sortKey="Anmella, Gerard" sort="Anmella, Gerard" uniqKey="Anmella G" first="Gerard" last="Anmella">Gerard Anmella</name><name sortKey="Goikolea, Jose M" sort="Goikolea, Jose M" uniqKey="Goikolea J" first="José M" last="Goikolea">José M. 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