A Canadian Naturalistic Study of a Community-based Cohort Treated for Bipolar Disorder
| Autor: | Barry Jones, Ranjith Chandresena, Bobbie Lee, Doron Sagman, Elizabeth Brunner |
|---|---|
| Rok vydání: | 2010 |
| Předmět: |
Adult
Male Olanzapine Canada medicine.medical_specialty Pediatrics Bipolar Disorder Personality Inventory lcsh:RC435-571 medicine.drug_class Bipolar disorder Health Status Suicide Attempted Psychiatry and Psychology Young Mania Rating Scale Severity of Illness Index Community-based cohort Cohort Studies Benzodiazepines lcsh:Psychiatry Surveys and Questionnaires Research article medicine Humans Psychiatry Psychiatric Status Rating Scales business.industry Data Collection Mood stabilizer Health Services medicine.disease Community Mental Health Services Naturalistic study Psychiatry and Mental health Treatment Outcome Acute Disease Montgomery–Åsberg Depression Rating Scale Cohort Quetiapine Female medicine.symptom business Mania Antipsychotic Agents Follow-Up Studies medicine.drug |
| Zdroj: | Psychiatry Publications BMC Psychiatry BMC Psychiatry, Vol 10, Iss 1, p 24 (2010) |
| Popis: | Background Bipolar illness is associated with significant psychosocial morbidity and health resource utilization. Second generation antipsychotics, used alone or in combination with mood stabilizers are effective in treating acute mania in community settings. This study was designed to compare the change in clinical parameters and resource utilization at one month in a group of patients who required treatment intervention for exacerbation of mania. The clinical response at one year was also evaluated. Methods 496 patients were enrolled at 75 psychiatric practices across Canada. The Olanzapine cohort (n = 287) included patients who had olanzapine added to their medication regimen or the dose of olanzapine increased. The Other cohort (n = 209) had a medication other than olanzapine added or the dose adjusted. Changes from baseline in the Young Mania Rating Scale (YMRS), Montgomery Asberg Depression Rating Scale, Beck Anxiety Inventory and SF-12 Health Survey were compared at one month using ANCOVA. Categorical variables at one month for health resource utilization, employment status, abuse/dependency, and the number of suicide attempts were compared using Fisher's Exact test. Patients were followed for one year and a subgroup was evaluated. Results At one month, patients in the Olanzapine cohort recorded a mean reduction in the YMRS of 11.5, significantly greater than the mean reduction in the Other cohort of 9.7 (ANCOVA P = 0.002). The Olanzapine cohort was significantly improved compared to the Other cohort on the scales for depression and anxiety and did not experience the deterioration in physical functioning seen in the Other cohort. No significant differences were detected in health-related quality-of-life measures, employment status, drug abuse/dependency, number of suicide attempts, mental functioning, emergency room visits or inpatient psychiatric hospitalizations. In a subgroup treated for 12 months with a single second generation antipsychotic, improvements in illness severity measures were maintained with no evidence of significant differences among the antipsychotics. Conclusions Patients with bipolar disorder requiring treatment intervention for exacerbation of mania in the community setting responded to olanzapine at one month. In a subset analysis, second generation antipsychotic treatment continued to be beneficial in reducing bipolar symptoms at one year. |
| Databáze: | OpenAIRE |
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