Will it happen again? Course of illness and predictors of relapse in first episode mania.

Poster B15, Tuesday, October 9, 11:30 am - 1:00 pm, Essex Ballroom

Melissa Hasty1, Susan Cotton1, Craig Macneil1, Kate Filia1, Michael Berk2, Aswin Ratheesh1, Philippe Conus3; 1Orygen, The National Centre of Excellence in Youth Mental Health, 2Deakin University, Impact Strategic Research Centre, 3Lausanne University Hospital, CHUV, Département de psychiatrie

Minimisation or denial of the risk of relapse is common following a first episode of mania. However, bipolar disorder can be a highly recurrent illness and unfortunately many young people do experience one or more relapses in the years following their initial episode. The aim of this study was to examine the early course of the disorder and identify factors associated with relapse in a youth population following treatment for first episode psychotic mania. Seventy-four patients treated at Orygen Youth Health in Melbourne, Australia and enrolled in a pharmacotherapy randomised controlled trial (RCT) were prospectively followed up for 18-months, with their course mapped through regular outpatient appointments and research assessment. The design of the RCT allowed close monitoring of the timing of symptom recurrences, changes to treatment, and examination of the association of clinical variables and medication status with relapse. Our study showed high rates of relapse early in the course of bipolar disorder despite high quality biopsychosocial treatment, with sixty-two percent of participants experiencing one or more affective and/or psychotic relapses. Results from logistic regression and survival analyses will be presented. Understanding risk factors for recurrence has important clinical implications, particularly for psychological early intervention aimed at relapse prevention.

Topic Area: Mood Disorders

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