MIXED EPISODES AS FIRT-EPISODE OF BIPOLAR DISORDER: INFLUENCE OF PREMORBID ADJUSTMENT IN LONG TERM FUNCTIONALITY. CIBERSAM Hospital Universitario de Álava-Santiago Universidad Nacional de Educación a Distancia-UNED Universidad del País Vasco-UPV M. Martínez-Cengotitabengoa S. Barbeito C. Bermúdez-Ampudia P. López A. Ugarte S. Alberich

OBJECTIVES The main objective was to assess the influence of premorbid adjustment at baseline in long-term functionality of a group of bipolar patients. As a second objective we tried to evaluate if this relathionship affects in the same way if patients had also depressive symptoms in addition to manic ones.

METHODS We included 75 patients with a first manic episode 34 patients with pure mania 41 patients with mixed mania. Premorbid adjustment was measured by Philips scale at baseline and patient functionality was assessed by Fast scale one year after the illness onset. In order to compare baseline charactersitic of both groups we used T-student test. To evaluate the influence of premorbid adjustment in functionality we used a linear regression model.

RESULTS (I) We found significant differences between groups only in Panss positive score (t=-3,282; p=0,001), so we use it as an adjustment variable in the linear regression model. For the whole sample we found that a worse premorbid adjustment was significantly related to a worse long-term functionality (B=2,981; p=0,008).

Mixed mania we observed that there was significantly influence of premorbid adjustment in functionality (B=3,844; p=0,024), the worst premorbid adjustment the worst functionality 1 year after. Pure mania There was not influence of premorbid adjustment in functionality (B=1,107; p=0,358). RESULTS (II)

CONCLUSIONS Premorbid adjustment in patients with a first episode of mania influence in long-term functionality if depressive symptoms are also present at the illness onset. ACKNOWLEDGEMENTS This work was supported by: Fondo de Investigación Sanitaria (PS09/02002; PI10/01430, PI10/01746, PI11/01977, PI11/02708, EC10-220, EC10-333), CAIBER (1392-D-079, 1677-DJ-030) y fondos locales del Gobierno del País Vasco ( , , , , KRONIK11/010, SAIO11-PE11BF006, SAIO11-PE11BF007); EITB (BIO09/EM/010) y la Universidad del País Vaco (GIC10/80, NNA6).