Objective: The aim of this study was to identify prognosis factors associated with recurrence in patients with bipolar disorder.
Method: This retrospective cohort study was conducted in Hamadan Province, the west of Iran. All patients (n = 400) with bipolar disorder who were hospitalized for the second time or more during April 2008 to September 2014 were included in this study. Ordinal logistic regression analysis was employed to determine the effective factors in each recurrence, and odds ratio (OR) and 95% confidence intervals (CI) were obtained.
Results: The mean (SD) age of the participants at the entrance to the study was 34.62 (11.68) years. There was an association between recurrence and type of bipolar disorder (P = 0.033). The OR of recurrence was 0.28 (95% CI: 0.09, 0.90) for bipolar disorder II; 0.35 (95% CI: 0.13, 0.92) for the patients with college education; 0.39 (95% CI: 0.25, 0.60) for employed patients; 0.55 (95% CI: 0.35, 0.87) for patients who received both drugs and electroconvulsive therapy, and 1.89 (95% CI: 1.23, 2.92) for patients who stopped using drugs. In addition, a non-significant association was found between recurrence and age, sex, marital status, place of residence, season, mood classification and family history of mood disorder.
Conclusion: Type of bipolar disorder and cessation of medication were the leading causes of an increase in the relapse of the disease. Furthermore, patients who received both drugs and electroconvulsive therapy had a fewer risk of recurrence.