10.6084/m9.figshare.4635592.v1
Radua J.
Radua
J.
Grunze H.
Grunze
H.
Amann B.L.
Amann
B.L.
Supplementary Material for: Meta-Analysis of the Risk of Subsequent Mood Episodes in Bipolar Disorder
Karger Publishers
2017
Bipolar disorder
Meta-analysis
Recurrence
Relapse
2017-02-09 15:05:20
Journal contribution
https://karger.figshare.com/articles/journal_contribution/Supplementary_Material_for_Meta-Analysis_of_the_Risk_of_Subsequent_Mood_Episodes_in_Bipolar_Disorder/4635592
<p><b><i>Background:</i></b> Reported relapse and recurrence rates in
bipolar disorder (BD) differ significantly between studies. Most data
originate from highly selective patients participating in sponsored
randomized controlled trials with narrow inclusion criteria. To estimate
the true risk of a subsequent mood episode (SME) under real-world
conditions, we conducted a meta-analysis of rates of SME as reported in
naturalistic BD studies. <b><i>Methods:</i></b> PubMed, ScienceDirect,
Scopus, and Web of Knowledge were searched until July 2015. Studies
reporting the time until the emergence of an SME, from which individual
data or Kaplan-Meier plots with censors marked could be retrieved, were
included. <b><i>Results:</i></b> Twelve studies comprising 5,837
patients met the inclusion criteria. The median time to an SME in adults
after an index episode was 1.44 years. The risk of an SME was 44%
during the first year. Not having a SME during this first year lowered
this risk to 19% in the second year. The risk was higher in bipolar II
disorder (BD-II) than in bipolar I disorder (BD-I; HR = 1.5). In BD-I,
the risk of a subsequent manic, mixed, or depressive mood episode was
higher after an index episode of the same polarity (HR = 1.89-5.14). The
overall risk of an SME was higher in patients with persisting
subsyndromal symptoms (HR = 2.17). <b><i>Conclusions:</i></b> The data
from this study provide a more reliable estimate of the risk of an SME
in BD in real-world settings. Further research into the longitudinal
course of BD-II is warranted to confirm its role as a risk factor for
SME.</p>