Prognosis of early-onset bipolar disorder compared to early-onset schizophrenia and healthy controls in a nationwide register based study.
Poster B13, Tuesday, October%209, 11:30%20am%20-%201:00%20pm, Essex%20Ballroom
Mathilde Frahm Laursen1,2, Rasmus Licht1,2, Jan Brink Valentin1, Christoph Correll3,4,5,6, René Ersnt Nielsen1,2,7; 1Unit for Psychiatric Research, Psychiatry – Aalborg University Hospital, 2Department of Clinical Medicine, Aalborg University, Aalborg, Denmark, 3The Zucker Hillside Hospital, Psychiatry Research, Northwell Health, 75-59 263rd Street, Glen Oaks, New York, NY 11004, USA, 4Hofstra Northwell School of Medicine, Hempstead, NY, USA, 5The Feinstein Institute for Medical Research, Manhasset, NY, USA, 6Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin, Berlin, Germany, 7Research and Treatment Program for Bipolar Disorder, Aalborg University Hospital, Denmark
Aims: To investigate differences in outcomes between early-onset bipolar disorder (BD) compared to schizophrenia and healthy controls. Methods: 5 to 17 years old patient diagnosed with BD (ICD-10 F30.X or F31.X) for the first time between 1995 and end of 2014 were included and matched 1:1 to schizophrenia (F20.X) and 1:3 to healthy controls. Several regression models investigating intentional self-harm acts, fracture and criminal charges in all groups and days hospitalized, admissions and outpatient contacts in patient groups were conducted, adjusted for family history of psychiatric disorder, substance misuse and age at first psychiatric contact. Results: The cohort comprised 365 youth with incident BD, 349 with incident schizophrenia and 1,095 healthy controls. The annual rate of days hospitalized were 16 days (95% CI: 12.69-18.80) in the BD cohort, and 33 days (95% CI: 27.88-37.94) for the schizophrenia cohort. Patients in the BD cohort had a decreased incidence rate ratio of admissions as compared to the schizophrenia cohort (IRR 0.44, 95%CI (0.41-0.48), P < 0.001), with similar results on of outpatient contacts (IRR=0.72, 95%CI (0.71-0.74), P<0.001), intentional self-harm acts (IRR=0.30, 95%CI (0.21-0.42), P<0.001), healthcare contacts due to fractures (IRR=0.68, 95%CI (0.50-0.91), P<0.01), and criminal charges (IRR=0.86, 95%CI (0.74-0.99), P<0.05). Patients in the BD cohort was associated with an increased IRR of intentional self-harm acts compared to healthy controls (IRR=2.80, 95%CI (1.75-4.48), P<0.001). Conclusions: Early-onset BD have a better prognosis compared to psychiatric controls, but worse than healthy controls. Further studies should focus on interventions to improve outcomes on intentional self-harm acts.
Topic Area: Mood Disorders