Bipolar disorder and its outcomes: two cohorts, 1875-1924 and 1994-2007, compared

Hist Psychiatry. 2016 Mar;27(1):75-84. doi: 10.1177/0957154X15624601. Epub 2016 Jan 14.

Abstract

We compared admission rates and outcomes for bipolar disorder patients using the medical records of patients with a first hospital admission in 1875-1924 retrospectively diagnosed based on International Classification of Diseases (ICD)-10 criteria, and patients with a first admission in 1994-2007. The incidences of first admissions in the historical and contemporary periods are comparable: 1.2 and 1.3 per hundred thousand per year, respectively. Manic episodes constituted a greater proportion of admissions historically, while depressive episodes made up more in the contemporary sample. There is no evidence for a reduction in the mean inter-admission intervals with duration of illness. This study suggests that modern treatments may have decreased lengths of stay in hospital, but at a cost of contributing to more admissions. It also points to a shift in the threshold for admissions.

Keywords: Bipolar disorder; hospitalization; incidence; manic-depressive illness; outcomes; relapse.

Publication types

  • Comparative Study
  • Historical Article

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Bipolar Disorder / history
  • Bipolar Disorder / therapy*
  • Delivery of Health Care* / history
  • Delivery of Health Care* / standards
  • Depression
  • Female
  • History, 19th Century
  • History, 20th Century
  • History, 21st Century
  • Hospitalization*
  • Humans
  • Length of Stay
  • Male
  • Mental Health Services* / history
  • Middle Aged
  • Patient Admission
  • Treatment Outcome
  • Young Adult