{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T16:17:17Z","timestamp":1787329037183,"version":"build-2736575974"},"reference-count":56,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2017,12,14]],"date-time":"2017-12-14T00:00:00Z","timestamp":1513209600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Bipolar Disorders"],"published-print":{"date-parts":[[2018,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>For the first time to estimate the risk of recurrence among patients with a single manic\/mixed episode by systematically reviewing prior studies on cohorts of adults, and cohorts of children and adolescents, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A systematic literature search up to August 2017 was carried out including studies in which &lt; 25% of the participants were estimated to have had a mood episode that required pharmacological treatment prior to the index manic or mixed episode at inclusion.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Three studies including a total of 293 adult patients with a single manic or mixed episode and three studies of children and adolescents including 126 patients were identified. In the adult studies, 31%, 40% and 42% experienced recurrence after recovery within 1\u00a0year, 59% after 2\u00a0years, and 58% after 4\u00a0years, respectively. In the studies on children and adolescents, 40% and 52% experienced recurrence after recovery within 1\u00a0year, 30% and 60% after 2\u00a0years and 64% and 67% after 4 to 5\u00a0years, respectively. Results from meta\u2010analyses showed a 1\u2010year rate of recurrence of 35% (95% confidence interval [<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>]: 30\u201041%) in adults, and in adolescents\/children, a 1\u2010year rate of recurrence of 48% (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>: 38\u201058%), a 2\u2010year rate of 46% (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>: 33\u201060%) and a 4\u20105\u2010year rate of recurrence of 65% (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>: 52\u201077%; as data from different studies were included at 1, 2 and 5\u00a0years, rates of recurrence did not increase steadily with time).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The rate of recurrence is high among adults as well as children and adolescents. It is important that clinicians and patients as well as relatives are well informed about these high risks when deciding to start maintenance treatment or not following onset of a single manic or mixed episode.<\/jats:p><\/jats:sec>","DOI":"10.1111\/bdi.12593","type":"journal-article","created":{"date-parts":[[2017,12,14]],"date-time":"2017-12-14T08:08:37Z","timestamp":1513238917000},"page":"9-17","source":"Crossref","is-referenced-by-count":40,"title":["Risk of recurrence after a single manic or mixed episode \u2013 a systematic review and meta\u2010analysis"],"prefix":"10.1111","volume":"20","author":[{"given":"Lars Vedel","family":"Kessing","sequence":"first","affiliation":[{"name":"Department O Psychiatric Center Copenhagen  Copenhagen Denmark"},{"name":"University of Copenhagen  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Per Kragh","family":"Andersen","sequence":"additional","affiliation":[{"name":"Department of Biostatistics University of Copenhagen  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maj","family":"Vinberg","sequence":"additional","affiliation":[{"name":"Department O Psychiatric Center Copenhagen  Copenhagen Denmark"},{"name":"University of Copenhagen  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,12,14]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.185.5.372"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.157.2.220"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/acps.12133"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/acps.12667"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0165-0327(98)00126-8"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0010-440X(00)90125-1"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0447.1985.tb10510.x"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.1985.01790330076009"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.3109\/15622975.2013.770551"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40345-014-0015-8"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.bp.113.142802"},{"key":"e_1_2_8_13_1","article-title":"The expert consensus guideline series: medication treatment of bipolar disorder 2000","author":"Sachs GS","year":"2000","journal-title":"Postgrad Med"},{"key":"e_1_2_8_14_1","unstructured":"R\u00e5det for Anvendelse af Dyr Sygehusmedicin (RADS).Baggrundsnotat for medicinsk behandling af bipolar lidelse.http:\/\/www.regioner.dk\/medicinsite\/rads\/behandlingsvejledninger\/~\/media\/2DCA28127D-004C4294342F7279E63252.ashx.2015. 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