Bipolar disorder (BPD) is one of the most common major mental illnesses, with international lifetime prevalence above 1% of the general population, affecting women and men of all ethnic groups. BPD has potential for high rates of recurrence, sustained morbidity, comorbidity (especially with substance-use and anxiety disorders), disability, and premature mortality-not only from extraordinarily high suicide rates, but also from stress-sensitive medical illnesses. To develop and implement sound and evidence-based clinical and public policies for treating BPD patients, much more information is required concerning their course and morbidity patterns, particularly from illness-onset. Information is emerging about morbidity, disability, and mortality in mid-course, but studies starting at the beginning of BPD illness remain rare. The McLean- Harvard First-Episode Project was organized by co-PI Dr. M. Tohen more than a decade ago, and continues in collaboration with PI, Professor RJ Baldessarini. The investigators have years of experience in psychiatric epidemiology and psychopharmacology research. The Project has followed the course of a large cohort of ca. 200 first-episode DSM-IV BPD (and other) patients systematically and prospectively for several years from a first hospitalization for a manic or mixed (manic-depressive) episode. The proposed study will analyze available project data to test the following important hypotheses: [1] administratively-based shortening of initial hospitalization in the 1990s will be associated with diminishing clinical improvement at discharge and rising early rehospitalization; [2] the major form of morbidity during follow-up will be depressive-dysphoric rather than manic or psychotic, with randomly distributed risk-by-time, and depression will be associated with poorer functional outcomes. Anticipated findings should contribute important new information to guide effective interventions and allocation of increasingly limited treatment resources for BPD patients.
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| Salvatore, P; Baldessarini, R J; Khalsa, H-M K et al. (2014) Antecedents of manic versus other first psychotic episodes in 263 bipolar I disorder patients. Acta Psychiatr Scand 129:275-85 |
| Faedda, Gianni L; Serra, Giulia; Marangoni, Ciro et al. (2014) Clinical risk factors for bipolar disorders: a systematic review of prospective studies. J Affect Disord 168:314-21 |
| Salvatore, Paola; Bhuvaneswar, Chaya; Tohen, Mauricio et al. (2014) Capgras' syndrome in first-episode psychotic disorders. Psychopathology 47:261-9 |
| Salvatore, Paola; Baldessarini, Ross J; Khalsa, Hari-Mandir K et al. (2013) Negative Affective Features in 516 Cases of First Psychotic Disorder Episodes: Relationship to Suicidal Risk. J Depress Anxiety 2: |
| Tohen, Mauricio; Khalsa, Hari-Mandir K; Salvatore, Paola et al. (2012) Two-year outcomes in first-episode psychotic depression the McLean-Harvard First-Episode Project. J Affect Disord 136:1-8 |
| Salvatore, Paola; Baldessarini, Ross J; Tohen, Mauricio et al. (2011) McLean-Harvard International First-Episode Project: two-year stability of ICD-10 diagnoses in 500 first-episode psychotic disorder patients. J Clin Psychiatry 72:183-93 |
| Baldessarini, Ross J; Salvatore, Paola; Khalsa, Hari-Mandir Kaur et al. (2010) Dissimilar morbidity following initial mania versus mixed-states in type-I bipolar disorder. J Affect Disord 126:299-302 |
| Baldessarini, Ross J; Salvatore, Paola; Khalsa, Hari-Mandir Kaur et al. (2010) Morbidity in 303 first-episode bipolar I disorder patients. Bipolar Disord 12:264-70 |
| Salvatore, Paola; Baldessarini, Ross J; Tohen, Mauricio et al. (2009) McLean-Harvard International First-Episode Project: two-year stability of DSM-IV diagnoses in 500 first-episode psychotic disorder patients. J Clin Psychiatry 70:458-66 |
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