recurrence in patients with bipolar disorder and its risk factors

objective: the aim of this study was to identify prognosis factors associated with recurrence in patients ‎with bipolar disorder.‎‎ method: this retrospective cohort study was conducted in hamadan province, the west of iran. all ‎patients (n = 400) with bipolar disorder who were hospitalized for the second time or more ‎during april 2008 to september 2014 were included in this study. ordinal logistic regression ‎analysis was employed to determine the effective factors in each recurrence, and odds ratio (or) and 95% confidence intervals (ci) were obtained.‎ results: the mean (sd) age of the participants at the entrance to the study was 34.62 (11.68) years. ‎there was an association between recurrence and type of bipolar disorder (p = 0.033). the ‎or of recurrence was 0.28 (95% ci: 0.09, 0.90) for bipolar disorder ii; 0.35 (95% ci: 0.13, ‎‎0.92) for the patients‎‏ ‏with college education; 0.39 (95% ci: 0.25, 0.60) for employed ‎patients; 0.55 (95% ci: 0.35, 0.87) for patients who received both drugs and ‎electroconvulsive therapy, and 1.89 (95% ci: 1.23, 2.92) for patients who stopped using ‎drugs. in addition, a non-significant association was found between recurrence and age, sex, ‎marital status, place of residence, season, mood classification and family history of mood ‎disorder.‎ conclusion: type of bipolar disorder and cessation of medication were the leading causes of an increase in ‎the relapse of the disease. furthermore, patients who received both drugs and ‎electroconvulsive therapy had a fewer risk of recurrence.‎