Length of hospital stay linked to mental impairments in bipolar patients

MedWire News: A longer stay in hospital is associated with greater impairments in certain mental abilities at discharge in patients with bipolar disorder, research shows.

Writing in the journal Comprehensive Psychiatry, Boaz Levy, from Harvard Medical School in Boston, Massachusetts, USA, and team explain that previous research has shown that a more severe course of bipolar disorder is associated with greater mental impairments.

To investigate whether length of hospital recovery from an acute mood episode is associated with mental impairments in bipolar disorders patients, the researchers studied 41 patients with the mood disorder who received inpatient treatment at McLean Hospital, Belmont, Massachusetts.

In all, 20 patients had a hospital stay that lasted longer than an average of 12 days, while the remaining 21 patients had a shorter stay.

All the participants underwent various tests to assess their memory, executive functioning (ability to plan and organise), attention and working memory and intelligence quotient (IQ).

There were no significant differences between long- and short-stay patients in terms of age at onset of bipolar disorder, previous number of psychiatric hospital admissions and number of psychiatric medications taken on the day of testing. There were also no differences in age, gender, depressive or manic symptoms, marital status or years of education between the two groups.

Analysis of the test results showed that patients with longer hospital stays had significantly worse short-term memory and recognition than those with shorter hospital stays, as well as marginally worse delayed recall and verbal memory.

In addition, patients with longer hospital stays had poorer performances on tests of executive functioning than those with shorter hospital stays.

There were no significant differences in attention and IQ between patients with longer and shorter hospital stays, however.

The team concludes in the journal Comprehensive Psychiatry: “The current data indicate that longer duration of hospital stay is correlated with more severe deficits in executive functioning during the phase of early remission.”

They add: “These results illuminate the challenges patients with bipolar disorder may face after discharge from a long inpatient admission and underscore the need to develop better care for their outpatient recovery.”