First-episode bipolar disorder

What is first-episode bipolar disorder?

The onset of bipolar disorder can be hard to identify, as early symptoms may be difficult to distinguish from normal mood fluctuations. Correct diagnosis and treatment is important because untreated illness may have an inherently ‘toxic’ effect, contributing to psychological deterioration and poor prognosis. An initial diagnosis of bipolar disorder usually follows the first distinct episode of mania, but may come after a long period of inappropriate treatments for other mood disorders.

What is the evidence for the course and outcome after a first-episode of bipolar disorder?

Moderate to high quality evidence suggests the mean interval between onset of symptoms of bipolar disorder and management of the disorder is around 6 years. Early age of onset of symptoms and bipolar II vs. bipolar I disorder were associated with longer treatment delays.

Moderate to low quality evidence finds the rates of symptom and functioning improvement and rates of relapse following a first hospitalisation for bipolar disorder vary widely between studies. For symptom improvement, sample rates varied between 26% and 98%, for functioning improvement, sample rates varied between 35% and 87%, and for relapse, sample rates varied between 21% and 74%.

April 2019

Last updated at: 4:20 am, 5th April 2019
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