Monitoring
Bipolar I disorder may require lifelong treatment and management. However, estimates from an 8 year longitudinal study of childhood bipolar I disorder suggest that the majority (55.6%) of childhood cases will not meet criteria for manic episodes by the ages of 18 years and above.[74] Patients experiencing acute episodes of mania should be monitored frequently until symptomatic improvement has taken place. Severe depression, the presence of serious suicidal thinking, or mania should prompt consideration of psychiatric hospitalization for protection of the patient and others, and to allow for daily monitoring and treatment planning. Patients discharged from hospital should be seen weekly, because the immediate postdischarge period may be associated with greater risk for nonadherence with treatment, relapse, and suicide. Information from family, patient, and even teachers, and the use of objective rating scales of mood and behavior, can enhance the monitoring of patient progress with treatment.[231]
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