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Substance use and a history of psychosis are risk factors for serious adverse events in people with bipolar disorder

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Q What clinical and demographic variables predict serious adverse events in people with bipolar disorder?


Embedded ImageDesign:

Prospective cohort study.

Embedded ImageFollow up period:

1 year.

Embedded ImageSetting:

Systematic Treatment Enhancement Program for Bipolar Disorder, multiple centres, USA; November 1999 to April 2002.

Embedded ImagePeople:

1000 people aged 15 years or older with DSM-IV bipolar disorder (bipolar I or II disorder, cyclothymia, bipolar disorder not otherwise specified, or schizoaffective disorder, bipolar subtype).

Embedded ImageRisk factors:

A large number of potential risk factors present at study entry were considered, including bipolar illness related variables (age at onset of bipolar illness, duration of illness, bipolar subtype, number of psychotropic medications, number of mood episodes, history of rapid cycling), other psychiatric variables (suicidal ideation, comorbid axis I diagnoses, family psychiatric history), and demographic variables (age, race, gender, …

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  • For correspondence: Dr James Martinez, Mood Disorders Center, Meninger Department of Psychiatry, Baylor Collage of Medicine, Ben Taub Hospital, 6655 Travis Street, Suite 560, Houston, TX 77030, USA; jmartine{at}

  • Source of funding: National Institute of Mental Health, contract N01-MH-80001.

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