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Voluntary vs. involuntary hospital admission in acute mania of bipolar disorder: Results from the Swiss sample of the EMBLEM study

Authors :
Schuepbach, Daniel
Goetz, Iris
Boeker, Heinz
Hell, Daniel
Source :
Journal of Affective Disorders. Jan2006, Vol. 90 Issue 1, p57-61. 5p.
Publication Year :
2006

Abstract

Abstract: Background: Patients with acute mania in bipolar disorder require pharmacological treatment to reduce symptoms. In addition, it is recognised that admission status is a clinically relevant aspect of bipolar disorder. There is, however, a lack of published data assessing the association of admission status with clinical or functional outcomes. The European-Mania-in-Bipolar-Longitudinal-Evaluation-of-Medication (EMBLEM) study has been designed to describe outcomes associated with medication therapies. Baseline data from this study are now available and we used these data to examine the characteristics of patients with acute mania in the Swiss EMBLEM cohort who were admitted involuntary and voluntary, respectively, and their functional and clinical status. Methods: Ninety-five patients with an acutely manic or mixed episode of bipolar disorder were included in the Swiss cohort of the study. Patients'' history, psychosocial functioning, clinical measures of mania and depression, pharmacological and compliance variables were assessed. Statistical methods comprised univariate analyses of variance and logistic regression analyses to elucidate associations between variables of interest. Results: Patients with involuntary hospital admission (n =55) were more aggressive and had less insight. They had a more frequent history of substance abuse and were less likely to take anticonvulsants or lithium. Furthermore, these patients showed lower compliance, which also guided physicians'' decision on pharmacotherapy. Limitation: The EMBLEM study had an observational and non-interventional design; therefore it was not possible to compare treatment groups by means of stringent between-group analyses. However, a main target of this study was to gather clinically relevant information on outcomes of acute mania associated with currently available medication therapies. Conclusions: Involuntary admission status was significantly associated with clinical status, especially aggression and also compliance. Admission status in bipolar patients plays a clinically important role. [Copyright &y& Elsevier]

Details

Language :
English
ISSN :
01650327
Volume :
90
Issue :
1
Database :
Academic Search Index
Journal :
Journal of Affective Disorders
Publication Type :
Academic Journal
Accession number :
19338389
Full Text :
https://doi.org/10.1016/j.jad.2005.09.012