The prognostic factors associated with longer index
episodes in the clinic group were more severe impairment during the index
episode (HR 3.27, 95 % CI 1.60 to 6.65), longer periods
of depression before treatment (HR 0.95, 95 % CI 0.92 to 0.99), and younger age at first psychiatric
episode (HR 1.12, 95 % CI 1.00 to 1.24).
Many young people with BD will present with symptoms
of depression before experiencing a full - blown manic
episode and may spend more time
of their illness being depressed than manic.