The American Journal of Psychiatry

Diagnosis of schizophrenia or bipolar disorder in the first episode of psychosis had remarkable stability over a decade in a study of over 450 patients. Nearly 90% of patients initially diagnosed with schizophrenia and 80% of those diagnosed with bipolar disorder retained that diagnosis. Many patients diagnosed with psychotic depression or other unspecified psychosis, as well as 15% of those initially diagnosed with bipolar disorder, were rediagnosed as having schizophrenia, generally because of increasing negative symptoms and poor psychosocial function.

This article describes a medical care management intervention for individuals with serious mental illness seeking treatment at a CMHC that showed positive outcomes complemented by decreased costs. However, despite the programs' effectiveness, it was deemed financially unsustainable after the study grant lapsed because nearly 60% of the population served were uninsured.

Mood disorder in over 2,200 pregnancies of over 1,100 women was examined to determine the risk for an episode. Among these women, 22.7% of those with bipolar disorder experienced an episode during pregnancy and 51.5% during the postpartum period. In comparison, 4.6% of those with unipolar disorder experienced an episode during pregnancy and 29.8% during the postpartum period. First lifetime episodes of mood disorder during the perinatal period occurred for 7.6% of women. Women who already had a mood disorder before their first pregnancy had the highest risk. These high risks are consistent with recommendations for close monitoring and continued treatment during and after pregnancy.