첫 조증 또는 혼재형 삽화로 입원한 양극성 장애 I형 환자의 유지기 치료중단율 및 관련 위험인자
Dropout Rate and Risk Factors of Dropout in the Maintenance Treatment of Bipolar I Patients with First Manic or Mixed Episode
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Objectives：Dropout is one of the important factors that may hinder successful treatment in the maintenance treatment of bipolar disorder. Dropout rates of bipolar patients have been reported in 32-51%, but there are lack of evidences about risk factors of dropout in bipolar I patients with the first manic or mixed episode. The aim of this study was to investigate the dropout rate and risk factors of dropout in bipolar I patients with the first manic or mixed episode. Method：Fifty eight bipolar I patients with the first manic or mixed episode were included in this study. We examined sociodemographic and clinical variables that may be associated with dropout by chart review retrospectively. Dropout for 2 year maintenance treatment was assessed by telephone interview. Cox proportional hazards regression model was used to assess risk factors affecting the time to dropout. Results：Dropout rate for 2 years in the maintenance treatment of bipolar I patients was 49.8%. Lower socioeconomic status, past impulsive behaviors, and lack of familial support for treatment were significantly associated with time to dropout in bipolar I patients. Conclusion：Dropout rates of bipolar patients with the first manic or mixed episode were high, and these were associated with socioeconomic status, impulsivity, and familial support. For the successful treatment of bipolar disorder patients, it is necessary to detect the high risk group of dropout and do psychosocial treatments in order to reduce dropout. Large-scaled, multicenter, and prospective studies are needed to confirm these results in the near future.
Abstract
Objectives：Dropout is one of the important factors that may hinder successful treatment in the maintenance treatment of bipolar disorder. Dropout rates of bipolar patients have been reported in 32-51%, but there are lack of evidences about risk factors of dropout in bipolar I patients with the first manic or mixed episode. The aim of this study was to investigate the dropout rate and risk factors of dropout in bipolar I patients with the first manic or mixed episode. Method：Fifty eight bipolar I patients with the first manic or mixed episode were included in this study. We examined sociodemographic and clinical variables that may be associated with dropout by chart review retrospectively. Dropout for 2 year maintenance treatment was assessed by telephone interview. Cox proportional hazards regression model was used to assess risk factors affecting the time to dropout. Results：Dropout rate for 2 years in the maintenance treatment of bipolar I patients was 49.8%. Lower socioeconomic status, past impulsive behaviors, and lack of familial support for treatment were significantly associated with time to dropout in bipolar I patients. Conclusion：Dropout rates of bipolar patients with the first manic or mixed episode were high, and these were associated with socioeconomic status, impulsivity, and familial support. For the successful treatment of bipolar disorder patients, it is necessary to detect the high risk group of dropout and do psychosocial treatments in order to reduce dropout. Large-scaled, multicenter, and prospective studies are needed to confirm these results in the near future.
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