METHODS
Subjects
In this retrospective investigation, we reviewed the
medical records of patients who were hospitalized in
the psychiatric ward of six university hospitals and
one psychiatric hospital in Korea from January 2003
to December 2010 due to an initial manic episode.
The patients were at least 20 years of age and were
clinically diagnosed according to DSM-IV criteria
with bipolar I disorder at the index hospitalization.
To examine the effects of specific medication regimens
on rehospitalization rates, all patients included
in this study had been discharged on lithium or
valproate along with an adjunctive atypical antipsychotic
(aripiprazole, olanzapine, risperidone, or
quetiapine). All participants had at least 12 months
of follow-up care and continued to receive the same
combination regimen they were on at discharge. The
following exclusion criteria were used: (i) pharmacological
treatment for a psychiatric disorder before the
index hospitalization; (ii) severe medical conditions;
(iii) axis I or axis II psychiatric disorders other than
bipolar I disorder; (iv) medication noncompliance
for more than 1 month; and (v) admission for
reasons other than a manic or hypomanic episode at
index hospitalization, including social reasons or
diagnostic purposes.