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The Current Course of Mood Disorders: A 3-Year Follow-Up

Published online by Cambridge University Press:  07 November 2014

Alessandro Lenzi ,
Fabrizio Lazzerini  and
Donatella Marazziti
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Abstract

The aim of this study was to evaluate the natural course of mood disorders in 157 patients admitted consecutively to the Dipartimento di Psichiatria, Neurobiologia, Farmacologia e Biotecnologie at Pisa University for an affective or schizoaffective episode and followed for 3 years.

During the follow-up, three patients committed suicide and three died of natural causes. The three suicide patients were diagnosed as suffering from a depressive episode deriving from Bipolar I disorder. Of the remaining 104 patients, 42% had no relapses, 35% had up to three relapses, and 23% had more than three relapses; there were no significant differences between these three groups.

In conclusion, recent treatments seem able to reduce the length and number of relapses in patients with mood disorders. The hyperthymic temperament seems to be a characteristic of compliant patients and a predictor of a good response to treatment. The mortality rate connected with somatic or accidental causes appears to be similar to that of the general population, while the rate of suicide is higher.

Type
Feature Articles
Information
CNS Spectrums , Volume 4 , Issue 5: Molecular Genetics: Part One , May 1999 , pp. 77 - 82
Copyright
Copyright © Cambridge University Press 1999

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References

REFERENCES

1.Kraepelin, E. Manic-Depressive Illness and Paranoia. Edinburgh, Scotland: Livingstone; 1921.Google Scholar
2.Pollock, HM. Recurrence of attacks in manic-depressive psychoses. Am J Psychiatry. 1931;11:567–574.CrossRefGoogle Scholar
3.Winokur, G, Kadrmas, A. A polyepisodic course in bipolar illness: possible clinical relationships. Comp Psychiatry. 1989;30:121–127.CrossRefGoogle ScholarPubMed
4.Angst, J. the course of affective disorders: II, typology of bipolar manic-depressive illness. Arch Psychiatr Nervenkranken. 1978;36:835–839.Google Scholar
5.Perris, C. The concept of cycloid psychotic disorder. Psychiatr Dev. 1988;6:37–56.Google ScholarPubMed
6.Zis, A, Goodwin, FK. Major affective disorder as a recurrent illness. Arch Gen Psychiatry. 1979;36:835–839.CrossRefGoogle ScholarPubMed
7.Swift, HM. The prognosis of recurrent insanity of manic-depressive type. American journal of Insanity. 1907;64:311–326.Google Scholar
8.Rennie, TAC. Prognosis in manic-depressive psychosis. Am J Psychiatry. 1942;98:801–814.CrossRefGoogle Scholar
9.Ravn, J. A comparison of past and present treatments of endogenous depression. Br J Psychiatry. 1966;112:501–504.CrossRefGoogle Scholar
10.Huston, PE, Locher, M. Manic-depressive psychosis: course when treated and untreated with electric shock. Arch Neurol Psychiatry. 1948;60:37–48.CrossRefGoogle ScholarPubMed
11.Baastrap, CP, Schou, M. Lithium as a prophylactic agent: its effect against reccurrent depression and manic-depressive psychosis. Arch Gen Psychiatry, 1967;16:162–172.Google Scholar
12.Kitner, GI, Ryan, CE, Miller, IW, Norman, WH. Recovery and major depression: factors associated with twelvemonth outcome. Am J Psychiatry. 1992;149:93–99.Google Scholar
13.Petterson, U. Manic-depressive illness. Acta Psychiatr Scand. 1977;69(suppl):1–93.Google Scholar
14.Himmelhoch, JM, Mulla, D, Neil, JF, Detre, TP, Kupfer, DJ. Incidence and significance of mixed affective states in a bipolar population. Arch Gen Psychiatry. 1976;33:1062–1066.CrossRefGoogle Scholar
15.Keller, MB, Shapiro, RW, Lavori, PW, Wolfe, N. Analysis with the life table and regression models. Arch Gen Psychiatry. 1982;39:905–915.CrossRefGoogle ScholarPubMed
16.Cohen, S, Khan, A, Robinson, J. Significance of mixed features in acute mania. Compr Psychiatry. 1988;29:421–426.CrossRefGoogle ScholarPubMed
17.Coryell, W, Keller, MM, Endicott, J, Andeason, N, Clayton, P, Hirschfeld, R. Bipolar II illness: course and outcome over a five-year period. Psychol Med. 1989;19:129–141.CrossRefGoogle ScholarPubMed
18.Fukuda, K. Etoh, T, Iwadate, T, Ishii, A. The course and prognosis of manic-depressive psychosis: a quantitative analysis of episodes and intervals. J Exp Med. 1982;139:299–307.Google Scholar
19.Angst, J. The course of affective disorders. In: Mood Disorders: Pharmacologic Prevention of Recurrences. Consensus Development Conference. National Institute of Mental Health; 1984.Google Scholar
20.Dion, GL, Tohen, M, Anthony, WA, Waternaux, CS. Symptoms and functioning of patients with depressive disorder six months after hospitalization. Hosp Comm Psychiatry. 1988;39:652–657.Google Scholar
21.Goodwin, FK, Jamison, KR, Manic-Depressive Illness. New York, NY: Oxford University Press; 1990.Google Scholar
22.Angst, J. The course of affective disorders. Psychopathology. 1986;19:47–52.CrossRefGoogle ScholarPubMed
23.Endicott, J, Nee, J, Andreasen, N, Clayton, P, Keller, M. Coryell, W. Bipolar II: combine or keep separate. J Affect Disord. 1985;8:17–28.CrossRefGoogle ScholarPubMed
24.Fuller, RG. Expectation of hospital life and outcome for mental patients on first admission. Psychiatr Q. 1930;4:295–323.CrossRefGoogle Scholar
25.Bond, ED, Braceland, FJ. Prognosis in mental disease: use of one-page abstracts. Am J Psychiatry. 1937;94:263–274.CrossRefGoogle Scholar
26.Hastings, DW. Follow-up results in psychiatric illness. Am J Psychiatry. 1958;114:1057–1066.CrossRefGoogle ScholarPubMed
27.Woodruff, RA Jr, Clayton, P, Guze, S. Suicide attempts and psychiatric diagnosis. Dis Nerv Syst. 1972;33:617–621.Google ScholarPubMed
28.Johnson, GF, Hunt, G, Suicidal behavior in bipolar manic-depressive patients and their families. Compr Psychiatry. 1979;20:159–164.CrossRefGoogle ScholarPubMed
29.Guze, SB, Robins, E. Suicide and primary affective disorders. Br J Psychiatry. 1970;117:437–438.CrossRefGoogle ScholarPubMed
30.Tsuang, MT. Suicide in schizophrenics, manics, depres-sives, and surgical controls. Arch Gen Psychiatry. 1978;35:153–155.CrossRefGoogle ScholarPubMed
31.Khuri, R, Akiskal, HS. Suicide prevention: the necessity of treating contributory psychiatric disorders. Psychiatr Clin North Am. 1983;6:193–207.CrossRefGoogle ScholarPubMed
32.Martin, R, Cloninger, C, Guze, S, Clayton, P. Mortality in a follow-up of 500 psychiatric outpatients. Arch Gen Psychiatry. 1985;42:58–66.CrossRefGoogle Scholar
33.American Psychiatric Association. Diagnostic and Statistical Manual of Mental disorder. 3rd ed. Revised. Washington, DC: American Psychiatric Association; 1987.Google Scholar
34.Cassano, GB, Musetti, L, Perugi, G, Mignani, V, McNair, DM, Akiskal, HS. A proposed new approach to the clinical subclassification of depressive illness. Pharmacopsychiatry. 1988;21:19–23.CrossRefGoogle Scholar
35.Akiskal, HS, Mallya, G. Criteria for the “soft” bipolar spectrum: treatment implication. Psychopharmacol Bull. 1987;23:68–73.Google Scholar
36.Statistical Package for the Social Sciences (SPSS). 2nd ed. MacGraw Hill; 1975.Google Scholar
37.Perris, C. A study of bipolar (manic-depressive) and unipolar recurrent depressive psychoses. 1-X. Acta Psychiatr Scand. 1966;194(suppl):172–183.CrossRefGoogle Scholar
38.Keller, MB, Lavori, PW, Coryell, W, et al.A differential outcom of pure manic, mixed/cycling, and pure depressive episodes in patients with bipolar illness. JAMA. 1986;255:3138–3142.CrossRefGoogle Scholar
39.Blackwell, B. Treatment adherence. Br J Psychiatry. 1976;29:513–531.CrossRefGoogle Scholar
40.Lenzi, A, Lazzerini, F, Placidi, GF, Cassano, GB, Askiskal, HS. Predictors of compliance with lithium and carbamazepine regimens in the long-term treatment of reccurent mood and related psychotic disorders. Pharmacopsychiatry. 1989;22:34–37.CrossRefGoogle Scholar
41. Institute Nazionale di Statistica. La mortalità in Italia. Collana d'Informazione N. 24, ISTAT, Roma; 1988.Google Scholar
42.Carlson, GA, Kotin, J, Davenport, Y. A follow-up of 53 bipolar manic depressive patients. Br J Psychiatry. 1974;124:134–139.CrossRefGoogle ScholarPubMed
43.Avison, WR, turner, RJ. Stressful life events and depressive symptoms: diaggregating the effects of acute stressors and chronic strains. J Health Soc Behav. 1988;29:253–264.CrossRefGoogle ScholarPubMed
44.Andrews, G, Neilson, M, Hunt, C, Steward, G, Kilohl, G. Diagnosis, personality, and the long term outcome of depression. Br J Psychiatry. 1990;157:13–18.CrossRefGoogle Scholar