Determinants of three-year clinical outcomes in real-world outpatients with bipolar disorder: The multicenter treatment survey for bipolar disorder in psychiatric outpatient clinics (MUSUBI)

Norio Sugawara; Naoto Adachi; Yukihisa Kubota; Yoichiro Watanabe; Kazuhira Miki; Takaharu Azekawa; Koji Edagawa; Eiichi Katsumoto; Seiji Hongo; Eiichiro Goto; Hitoshi Ueda; Masaki Kato; Reiji Yoshimura; Atsuo Nakagawa; Toshiaki Kikuchi; Takashi Tsuboi; Koichiro Watanabe; Kazutaka Shimoda; Norio Yasui-Furukori

doi:10.1016/j.jpsychires.2022.05.028

Determinants of three-year clinical outcomes in real-world outpatients with bipolar disorder: The multicenter treatment survey for bipolar disorder in psychiatric outpatient clinics (MUSUBI)

J Psychiatr Res. 2022 Jul:151:683-692. doi: 10.1016/j.jpsychires.2022.05.028. Epub 2022 May 24.

Authors

Norio Sugawara¹, Naoto Adachi², Yukihisa Kubota³, Yoichiro Watanabe⁴, Kazuhira Miki⁵, Takaharu Azekawa⁶, Koji Edagawa⁷, Eiichi Katsumoto⁸, Seiji Hongo⁹, Eiichiro Goto¹⁰, Hitoshi Ueda¹¹, Masaki Kato¹², Reiji Yoshimura¹³, Atsuo Nakagawa¹⁴, Toshiaki Kikuchi¹⁵, Takashi Tsuboi¹⁶, Koichiro Watanabe¹⁷, Kazutaka Shimoda¹⁸, Norio Yasui-Furukori¹⁹

Affiliations

¹ Department of Psychiatry, Dokkyo Medical University School of Medicine, Tochigi, Japan; The Japanese Society of Clinical Neuropsychopharmacology, Tokyo, Japan. Electronic address: [email protected].
² The Japanese Association of Neuro-Psychiatric Clinics, Tokyo, Japan. Electronic address: [email protected].
³ The Japanese Association of Neuro-Psychiatric Clinics, Tokyo, Japan. Electronic address: [email protected].
⁴ The Japanese Association of Neuro-Psychiatric Clinics, Tokyo, Japan. Electronic address: [email protected].
⁵ The Japanese Association of Neuro-Psychiatric Clinics, Tokyo, Japan. Electronic address: [email protected].
⁶ The Japanese Association of Neuro-Psychiatric Clinics, Tokyo, Japan. Electronic address: [email protected].
⁷ The Japanese Association of Neuro-Psychiatric Clinics, Tokyo, Japan. Electronic address: [email protected].
⁸ The Japanese Association of Neuro-Psychiatric Clinics, Tokyo, Japan. Electronic address: [email protected].
⁹ The Japanese Association of Neuro-Psychiatric Clinics, Tokyo, Japan. Electronic address: [email protected].
¹⁰ The Japanese Association of Neuro-Psychiatric Clinics, Tokyo, Japan. Electronic address: [email protected].
¹¹ The Japanese Association of Neuro-Psychiatric Clinics, Tokyo, Japan. Electronic address: [email protected].
¹² The Japanese Society of Clinical Neuropsychopharmacology, Tokyo, Japan; Department of Neuropsychiatry, Kansai Medical University, Osaka, Japan. Electronic address: [email protected].
¹³ The Japanese Society of Clinical Neuropsychopharmacology, Tokyo, Japan; Department of Psychiatry, University of Occupational and Environmental Health, Fukuoka, Japan. Electronic address: [email protected].
¹⁴ The Japanese Society of Clinical Neuropsychopharmacology, Tokyo, Japan; Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan. Electronic address: [email protected].
¹⁵ The Japanese Society of Clinical Neuropsychopharmacology, Tokyo, Japan; Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan. Electronic address: [email protected].
¹⁶ The Japanese Society of Clinical Neuropsychopharmacology, Tokyo, Japan; Department of Neuropsychiatry, Kyorin University School of Medicine, Tokyo, Japan. Electronic address: [email protected].
¹⁷ The Japanese Society of Clinical Neuropsychopharmacology, Tokyo, Japan; Department of Neuropsychiatry, Kyorin University School of Medicine, Tokyo, Japan. Electronic address: [email protected].
¹⁸ Department of Psychiatry, Dokkyo Medical University School of Medicine, Tochigi, Japan; The Japanese Society of Clinical Neuropsychopharmacology, Tokyo, Japan. Electronic address: [email protected].
¹⁹ Department of Psychiatry, Dokkyo Medical University School of Medicine, Tochigi, Japan; The Japanese Society of Clinical Neuropsychopharmacology, Tokyo, Japan. Electronic address: [email protected].

PMID: 35675718
DOI: 10.1016/j.jpsychires.2022.05.028

Abstract

Background: There is limited evidence regarding predictors of long-term clinical outcomes in patients with bipolar disorder (BD). The objective of this study was to describe 3-year clinical outcomes and identify their predictors from participants in the multicenter treatment survey for BD in psychiatric outpatient clinics (MUSUBI).

Methods: The MUSUBI was a naturalistic study investigating patients with BD in real-world clinical practice. Our study extracted data regarding 1647 outpatients with BD from 2016, 2017, and 2019 as baseline, 1-year, and 3-year assessments. As clinical outcomes, we assessed the presence of time ill (depressive and manic) during the 1 year prior to the 3-year assessment and durable remission (53 weeks or more) prior to the 3-year assessment.

Results: Participants with durable remission prior to the 3-year assessment had significant associations with diagnosis of a personality disorder and duration of continuous remission at baseline. Regarding the presence of depressive symptoms during the 1 year prior to the 3-year assessment, work status, Global Assessment of Functioning (GAF) scores, suicidal ideation, and duration of continuous remission at baseline had significant associations with this outcome.

Conclusions: At the 3-year assessment, 19.3% of participants (318/1647) achieved durable remission, while 47.5% of them (782/1647) were not remitted. Our findings can help clinicians predict the illness course of BD by understanding demographic and clinical characteristics.

Keywords: Bipolar disorder; Depression; Mania; Naturalistic study.

Publication types

Multicenter Study
Research Support, Non-U.S. Gov't

MeSH terms

Ambulatory Care Facilities
Bipolar Disorder* / diagnosis
Bipolar Disorder* / epidemiology
Bipolar Disorder* / therapy
Humans
Outpatients
Personality Disorders / complications
Suicidal Ideation