Personality disorder among youth with first episode psychotic mania: An important target for specific treatment?

Autor: Melissa K. Hasty, Philippe Conus, Julie Ramain, Sue M. Cotton, Aswin Ratheesh, Craig Macneil, Michael Berk, Linda Kader, Andrew M. Chanen
Rok vydání: 2021
Předmět:
Olanzapine
Adult
medicine.medical_specialty
Bipolar Disorder
Adolescent
media_common.quotation_subject
Personality Disorders
law.invention
03 medical and health sciences
Young Adult
0302 clinical medicine
Randomized controlled trial
Bipolar Disorder/complications
Bipolar Disorder/drug therapy
Bipolar Disorder/epidemiology
Humans
Mania
Olanzapine/therapeutic use
Personality Disorders/complications
Personality Disorders/epidemiology
Treatment Outcome
bipolar disorder
depression
first episode
mania
personality disorder
law
mental disorders
medicine
Personality
Bipolar disorder
Psychiatry
Biological Psychiatry
media_common
First episode
business.industry
medicine.disease
Comorbidity
030227 psychiatry
Psychiatry and Mental health
Cohort
Pshychiatric Mental Health
medicine.symptom
business
030217 neurology & neurosurgery
medicine.drug
Zdroj: Early intervention in psychiatry, vol. 16, no. 3, pp. 256-263
ISSN: 1751-7893
Popis: Aim Personality disorder is a common co-occurrence ('comorbidity') among patients with bipolar disorder and appears to affect outcome negatively. However, there is little knowledge about the impact of this comorbidity in the early phases of bipolar disorder. We examined the prevalence and effect of personality disorder co-occurrence on outcome in a cohort of youth with first episode mania with psychotic features. Methods Seventy-one first episode mania patients, aged 15-29, were assessed at baseline, 6, 12, and 18 months as part of a randomized controlled trial of olanzapine and chlorpromazine as add-on to lithium in first episode mania with psychotic features. The current study involved secondary analysis of trial data. Results A co-occurring clinical personality disorder diagnosis was present in 16.9% of patients. Antisocial and narcissistic personality disorders were the most common diagnoses. Patients with co-occurring personality disorder had higher rates of readmission to hospital, lower rates of symptomatic recovery and poorer functional levels at 6 months, but these differences disappeared after 12 and 18 months. Conclusions In the early phase of bipolar disorder, patients with personality disorder comorbidity display delayed symptomatic and functional recovery and increased likelihood to need hospital readmissions. These observations suggest that routine assessment for personality disorder and specific interventions are important in order to improve short-term treatment efficacy in this subgroup.
Databáze: OpenAIRE
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