Bipolar patients in community mental health centers and specialized units. Could they be pooled?

Introduction: Bipolar patients recruited for studies are usually picked from Bipolar Disorder Units, which only contain a fraction of the total population of patients with bipolar disorder. The purpose of this study was to determine whether the course of the illness is comparable in patients from a Community Mental Health Center (CMHC) and those from a Bipolar Disorder Unit (BDU).

Methods: This study was carried out at the La Fe Teaching Hospital BDU and two CMCH. Data were collected from the patients' clinical records and were completed by a face-toface interview. When the latter was not possible, a telephone interview was carried out. Demographic, clinical and course-of-illness variables were gathered.

Results: There were no differences in demographic characteristics between the two patient groups. Differences were found in clinical data: BDU patients were younger at illness onset (p<0.005), were admitted more frequently (p<0.05), and stayed longer in the hospital (p<0.005).

Conclusions: Bipolar patients treated at a CMHC show clear differences compared with those from a BDU. Consequently, care should be exercised when generalizing the clinical course of bipolar patients using BDU samples. These patients are not representative of the total bipolar patient population, as their clinical course is more complicated.