Factors associated with non-remission in bipolar disorder: The multicenter treatment survey for bipolar disorder in psychiatric outpatient clinics (musubi)

Takashi Tsuboi, Takefumi Suzuki, Takaharu Azekawa, Naoto Adachi, Hitoshi Ueda, Kouji Edagawa, Eiichi Katsumoto, Yukihisa Kubota, Eiichiro Goto, Seiji Hongo, Yoichiro Watanabe, Masaki Kato, Norio Yasui-Furukori, Reiji Yoshimura, Atsuo Nakagawa, Toshiaki Kikuchi, Koichiro Watanabe

Research output: Contribution to journalArticle

Abstract

Purpose: The aim of this study was to identify factors associated with non-remission in bipolar disorder. Patients and Methods: The multicenter treatment survey for bipolar disorder in psychiatric outpatient clinics (MUSUBI) study used a questionnaire administered at 176 clinics throughout Japan from September to October 2016. Clinic psychiatrists performed a retrospective medical record survey of consecutive cases with bipolar disorder. Patients were considered to be in remission if they met all of the following criteria: they were not in a mixed state, their manic or depressive symptoms were either borderline or nonexistent (corresponding to 2 or 1 points on the Clinical Global Impressions Scale, Bipolar Version), and their psychiatrists clinically considered them to be in remission. Enrolled patients were classified into remitters group and non-remitters group and demographic and clinical characteristics were contrasted between the groups. Non-remitters were compared with remitters, using a series of logistic regression analyses. Results: A total of 3130 patients (1420 men; mean age: 50.3 years) were included in this study; 1307 patients (41.8%) were in remission. Of the remaining 1823 patients, 1260 (40.3%) had mild to severe depression, 261 (8.3%) suffered from manic or hypomanic episodes, and 302 (9.6%) were in a mixed state. Logistic regression analyses found the following eight factors to be significantly correlated with non-remission in patients with bipolar disorder: female gender, younger age, unemployed status, rapid cycling pattern, comorbid alcohol/substance abuse, poorer social function, lithium non-use, and antidepressant use. Conclusion: The MUSUBI study, the largest nationwide investigation on bipolar disorder, identified eight clinically relevant factors associated with non-remission in bipolar patients. They have important clinical implications; further prospective studies are necessary to replicate these findings and to guide better managements for those in serious needs.

Original languageEnglish
Pages (from-to)881-890
Number of pages10
JournalNeuropsychiatric Disease and Treatment
Volume16
DOIs
Publication statusPublished - 2020 Jan 1

Keywords

  • Antipsychotics
  • Bipolar disorder
  • Mood stabilizer
  • Nationwide study
  • Non-remission

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Biological Psychiatry

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    Tsuboi, T., Suzuki, T., Azekawa, T., Adachi, N., Ueda, H., Edagawa, K., Katsumoto, E., Kubota, Y., Goto, E., Hongo, S., Watanabe, Y., Kato, M., Yasui-Furukori, N., Yoshimura, R., Nakagawa, A., Kikuchi, T., & Watanabe, K. (2020). Factors associated with non-remission in bipolar disorder: The multicenter treatment survey for bipolar disorder in psychiatric outpatient clinics (musubi). Neuropsychiatric Disease and Treatment, 16, 881-890. https://doi.org/10.2147/NDT.S246136