The progression trajectory of Bipolar Disorder: results from the application of a staging model over a ten-year observation.

Autor: Cremaschi L; University of Milan, Department of Mental Health, Department of Biomedical and Clinical Sciences Luigi Sacco, Milan, Italy. Electronic address: laura.cremaschi@unimi.it., Macellaro M; University of Milan, Department of Mental Health, Department of Biomedical and Clinical Sciences Luigi Sacco, Milan, Italy; 'Aldo Ravelli' Center for Neurotechnology and Brain Therapeutic, University of Milan, Milan, Italy., Girone N; University of Milan, Department of Mental Health, Department of Biomedical and Clinical Sciences Luigi Sacco, Milan, Italy., Bosi M; University of Milan, Department of Mental Health, Department of Biomedical and Clinical Sciences Luigi Sacco, Milan, Italy., Cesana BM; University of Milan, Department of Clinical Sciences and Community Health, Unit of Medical Statistics, Biometry and Bioinformatics 'Giulio A. Maccacaro', Faculty of Medicine and Surgery, Milan, Italy., Ambrogi F; University of Milan, Department of Clinical Sciences and Community Health, Unit of Medical Statistics, Biometry and Bioinformatics 'Giulio A. Maccacaro', Faculty of Medicine and Surgery, Milan, Italy., Dell'Osso B; University of Milan, Department of Mental Health, Department of Biomedical and Clinical Sciences Luigi Sacco, Milan, Italy; Stanford University, Department of Psychiatry and Behavioral Sciences, Bipolar Disorders Clinic, CA, USA; 'Aldo Ravelli' Center for Neurotechnology and Brain Therapeutic, University of Milan, Milan, Italy.
Jazyk: angličtina
Zdroj: Journal of affective disorders [J Affect Disord] 2024 Oct 01; Vol. 362, pp. 186-193. Date of Electronic Publication: 2024 Jun 27.
DOI: 10.1016/j.jad.2024.06.094
Abstrakt: Background: Trying to better define Bipolar Disorder (BD) progression, different staging models have been conceptualized, each one emphasizing different aspects of illness. In a previous article we retrospectively applied the main staging models to a sample of 100 bipolar patients at four time points over a ten-year observation. In the present study, focusing on Kupka & Hillegers's model, we aimed to assess the transition of the same sample through the different stages of illness and to explore the potential role of clinical variables on the risk of progression.
Methods: Multistate Model using the mstate package in R and Markov model with stratified hazards were used for statistical analysis.
Results: A high hazard of transition from stage 2 to 3 emerged, with a probability of staying in stage 2 decreasing to 14 % after 3 years. BD II was significantly associated with transition from stage 1 to 2, whereas the number of lifetime episodes >3 and the elevated predominant polarity with transition from stage 3 to 4.
Conclusion: Our results corroborated the evidence on BD progression and contributed to outline its trajectory over time. Further effort may help to define a standardized staging approach towards ever increasing tailored interventions.
Competing Interests: Declaration of competing interest In the last three years, Prof. Dell'Osso has received lecture honoraria and grants from Angelini, Lundbeck, Janssen, Pfizer, Otzuka, Neuraxpharm, and Livanova. The other authors have no conflicts to declare.
(Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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