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

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State: Public
Version: Author's accepted manuscript
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Serval ID
serval:BIB_63583A080E57
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Personality disorder among youth with first episode psychotic mania: An important target for specific treatment?
Journal
Early intervention in psychiatry
Author(s)
Hasty M.K., Macneil C.A., Cotton S.M., Berk M., Kader L., Ratheesh A., Ramain J., Chanen A.M., Conus P.
ISSN
1751-7893 (Electronic)
ISSN-L
1751-7885
Publication state
In Press
Peer-reviewed
Oui
Language
english
Notes
Publication types: Journal Article
Publication Status: aheadofprint
Abstract
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.
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.
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.
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.
Keywords
bipolar disorder, depression, first episode, mania, personality disorder
Pubmed
Web of science
Open Access
Yes
Create date
17/03/2021 9:32
Last modification date
10/04/2021 5:33
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