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Do prospective longitudinal studies of bipolar disorder support the hypothesis of neuroprogression?

Published online by Cambridge University Press:  19 July 2023

I. Melle ,
T. V. Lagerberg ,
B. Etain ,
S. H. Lyngstad  and
K. F. Wold
I. Melle*
Affiliation:
1Research and innovation, Oslo university hospital, Oslo, Norway
T. V. Lagerberg
Affiliation:
1Research and innovation, Oslo university hospital, Oslo, Norway
B. Etain
Affiliation:
2Centre Expert Trouble Bipolaire, Hôpital Lariboisière - F. Widal, Paris, France
S. H. Lyngstad
Affiliation:
3Nydalen DPS, Oslo university hospital
K. F. Wold
Affiliation:
4Institute of clinical medicine, University of Oslo, Oslo, Norway
*
*Corresponding author.

Abstract

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Introduction

Bipolar I disorder is a mental disorder with the risk of severe clinical outcomes. Bipolar disorder was initially defined based on having a better outcome than schizophrenia. However, while recent longer-term findings in schizophrenia do not support neuroprogression, bipolar disorder is increasingly depicted as having neuroprogressive elements. There are, however, remarkably few prospective longitudinal studies of representative bipolar I cohorts followed from the first treatment.

Objectives

To study the clinical development of a representative cohort of bipolar disorder patients recruited at their first treatment.

Methods

Patients with DSM-IV Bipolar I or Bipolar NOS were consecutively recruited from in-and outpatient units in the larger Oslo area during their first treatment year and extensively clinically characterized at baseline. They then participated in personal one- and ten-year follow-ups.

Results

Sixty-nine patients participated in the 10-year follow-up. Age at follow-up was 39.0 (+ 9.6) years, 59% were females. A total of 12% had unipolar mania, 58% had psychotic bipolar disorder, and 20% had experienced rapid cycling. At follow-up, 75% were in full affective remission, 60% had regained full functioning, and 54% were in stable full recovery.

Mood episode relapses clustered around the first episode. Despite occasional relapses, 2/3 were mainly euthymic during the follow-up period. A small sub-group was highly affected from the first 2-3 years of treatment, but there were no apparent signs of kindling effects or indications of neuroprogression

Conclusions

The follow-up of this cohort of first-treatment Bipolar I patients does not support the hypothesis of neuroprogression.

Disclosure of Interest

None Declared

Type
Abstract
Information
European Psychiatry , Volume 66 , Special Issue S1: Abstracts of the 31st European Congress of Psychiatry , March 2023 , pp. S198 - S199
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2023. Published by Cambridge University Press on behalf of the European Psychiatric Association
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