Are personality disorders in bipolar patients more frequent in the US than Europe?

Autor: Post RM; Bipolar Collaborative Network, Chevy Chase, MD, United States. Electronic address: robert.postmd@gmail.com., Leverich GS; Bipolar Collaborative Network, Chevy Chase, MD, United States., McElroy SL; Linder Center of Hope, Mason, OH, and Biological Psychiatry Program, University of Cincinnati Medical College, Cincinnati, OH, United States., Kupka R; VU University Medical Center, Department of Psychiatry, Amsterdam, the Netherlands., Suppes T; 11 Professor of Psychiatry and Behavioral Sciences, Stanford University School of Medicine and V.A. Palo Alto Health Care System Palo Alto, CA V.A, United States., Altshuler LL; UCLA Mood Disorders Research Program and VA Medical Center, Los Angeles, CA, United States., Nolen WA; Universitair Medisch Centrum Groningen (UMCG), Groningen, the Netherlands., Frye MA; Professor of Psychiatry, Mayo Clinic, Rochester, MI, United States., Keck PE; Linder Center of Hope, Mason, OH, and Biological Psychiatry Program, University of Cincinnati Medical College, Cincinnati, OH, United States; Professor of Psychiatry & Neuroscience, University of Cincinnati College of Medicine Cincinnati, OH, President-CEO Lindner Center of HOPE Mason, OH, United States., Grunze H; Psychiatrie Schwäbisch Hall & Paracelsus Medical University Nuremberg, Germany., Rowe M; Biostatistician Bipolar Collaborative Network, Chevy Chase, MD, United States.
Jazyk: angličtina
Zdroj: European neuropsychopharmacology : the journal of the European College of Neuropsychopharmacology [Eur Neuropsychopharmacol] 2022 May; Vol. 58, pp. 47-54. Date of Electronic Publication: 2022 Feb 25.
DOI: 10.1016/j.euroneuro.2022.02.007
Abstrakt: Objective: Bipolar patients in the United States (US) compared to those from the Netherlands and Germany (here abbrev. as "Europe") have more Axis I comorbidities and more poor prognosis factors such as early onset and psychosocial adversity in childhood. We wished to examine whether these differences also extended to Axis II personality disorders (PDs).
Methods: 793 outpatients with bipolar disorder diagnosed by SCID gave informed consent for participating in a prospective longitudinal follow up study with clinician ratings at each visit. They completed detailed patient questionnaires and a 99 item personality disorder inventory (PDQ-4). US versus European differences in PDs were examined in univariate analyses and then logistic regressions, controlling for severity of depression, age, gender, and other poor prognosis factors.
Results: In the univariate analysis, 7 PDs were more prevalent in the US than in Europe, including antisocial, avoidant, borderline, depressive, histrionic, obsessive compulsive, and schizoid PDs. In the multivariate analysis, the last 4 of these PDs remained independently greater in the US than Europe.
Conclusions: Although limited by use of self report and other potentially confounding factors, multiple PDs were more prevalent in the US than in Europe, but these preliminary findings need to be confirmed using other methodologies. Other poor prognosis factors are prevalent in the US, including early age of onset, more childhood adversity, anxiety and substance abuse comorbidity, and more episodes and rapid cycling. The interactions among these variables in relationship to the more adverse course of illness in the US than in Europe require further study.
Competing Interests: Conflict of interest Trisha Suppes, MD, PhD, in the past 36 months has reported grants from Merck, National Institute of Health, National Institute of Mental Health, National Institute on Drug Abuse, Palo Alto Health Sciences, Pathways Genomics, Stanley Medical Research Institute, VA Cooperative Studies Program, and VA OR&D PRIME Care; consulting fees from Allergan, Inc., Impel NeuroPharma Inc., and Sunovion Pharmaceuticals Inc.; honoraria from CME Institute (underwritten by Otsuka), CMEology, Global Medical Education, and Medscape Education; royalties from Jones and Bartlett, Hogrefe Publishing and Wolters Kluwer Health (UpToDate); and travel reimbursement from CMEology, Global Medication Education, and Sunovion Pharmaceuticals, Inc.
(Copyright © 2022. Published by Elsevier B.V.)
Databáze: MEDLINE
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