One-year rehospitalization rates of patients with first-episode bipolar mania receiving lithium or valproate and adjunctive atypical antipsychotics
Article first published online: 10 FEB 2014
© 2014 The Authors. Psychiatry and Clinical Neurosciences © 2014 Japanese Society of Psychiatry and Neurology
Psychiatry and Clinical Neurosciences
Volume 68, Issue 6, pages 418–424, June 2014
How to Cite
Woo, Y. S., Bahk, W.-M., Jung, Y.-E., Jeong, J.-H., Lee, H.-B., Won, S.-H., Lee, K. H., Jon, D.-I., Yoon, B.-H., Kim, M.-D. and Min, K. J. (2014), One-year rehospitalization rates of patients with first-episode bipolar mania receiving lithium or valproate and adjunctive atypical antipsychotics. Psychiatry and Clinical Neurosciences, 68: 418–424. doi: 10.1111/pcn.12145
- Issue published online: 3 JUN 2014
- Article first published online: 10 FEB 2014
- Manuscript Accepted: 4 DEC 2013
- Manuscript Revised: 5 NOV 2013
- Manuscript Received: 10 JUL 2013
- bipolar disorder;
We compared the 1-year rehospitalization rates of first-episode bipolar manic patients who were discharged while being treated with lithium or valproate in combination with an atypical antipsychotic.
We investigated the rehospitalization status of first-episode bipolar manic patients who were discharged between 1 January 2003 and 31 December 2010 while they were taking lithium or valproate in combination with aripiprazole, olanzapine, quetiapine, or risperidone. Rehospitalization rates during a 1-year period after discharge were compared between the group receiving lithium plus an atypical antipsychotic and the group receiving valproate plus an atypical antipsychotic using the Kaplan–Meier method. A Cox regression model was used to analyze covariates hypothesized to affect time to rehospitalization.
The rehospitalization rate was 17.3% during the 1-year follow-up period. We found significant differences in the rehospitalization rates of patients in the lithium (23.1%) and the valproate (13.3%) groups using the Kaplan–Meier formula. According to Cox proportional hazards regression analysis, higher Clinical Global Impression–Bipolar Version–Severity score at discharge (P = 0.005) and lithium treatment (P = 0.055) contributed to the risk of rehospitalization.
Treatment with valproate and an atypical antipsychotic can be more effective than treatment with lithium and an atypical antipsychotic in preventing rehospitalization during the 1 year after hospitalization due to a first manic episode in patients with bipolar I disorder. Higher Clinical Global Impression–Bipolar Version–Severity scores at discharge also negatively affected rehospitalization rates.