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Clinical outcome in bipolar disorder in a community-based follow-up study in Butajira, Ethiopia

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Fekadu A, Kebede D, Alem A, Fekadu D, Mogga S, Negash A, Medhin G, Beyero T, Shibre T. Clinical outcome in bipolar disorder in a community-based follow-up study in Butajira, Ethiopia. Objective: 

To determine the clinical outcome of bipolar disorder in a developing country setup. Method: 

After assessing 68 378 individuals, aged 15–49 years, in a double-sampling design in a rural community in Ethiopia, 312 patients with bipolar disorder were prospectively monitored with symptom rating scales and clinically for an average of 2.5 years. Results: 

Overall, 65.9% of the cohort experienced a relapse – 47.8% manic, 44.3% depressive and 7.7% mixed episodes – and 31.1% had persistent illness. Female gender predicted depressive relapse, while male gender predicted manic relapse. Being on psychotropic medication was associated with remission. Conclusion: 

This large community-based study confirms the relapsing nature of bipolar disorder and a tendency for chronicity. This may be partly because of lack of appropriate interventions in this setting; however, it may also indicate the underlying severity of the disorder irrespective of setting.

Keywords: antipsychotics; bipolar disorder; developing country; remission

Document Type: Research Article


Affiliations: 1: Community Health 2: Psychiatry 3: Institute of Psychiatry, Kings College London, London 4: Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia

Publication date: 2006-12-01

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