Figure 1.

Detailed record of the scores of clinical scales during in-patient treatment.

Notes: As quetiapine was already initiated before hospitalization, it was continued at a dose of 400 mg/day after admission and gradually titrated up to 700 mg/d in 2 weeks. Valproate was initiated in the second week and titrated up to 1,000 mg/d in 1 week. Aripiprazole was added 3 weeks after admission at an initial dose of 5 mg/d and increased to 10 mg/d 3 days later.

Abbreviations: HAMD-24, Hamilton depression rating scale (24 items); BRMS, Beth–Rafaelsen mania scale; Y-BOCS, Yale–Brown obsessive–compulsive scale.