Predictors of recurrence during long-term treatment of bipolar I and II disorders. A 4 year prospective naturalistic study
| Autor: | Antonio Tundo, Alessandra Benedetti, I. Pergentini, Erika Cambiali, Enrico Massimetti, Liliana Dell'Osso, Laura Musetti |
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| Rok vydání: | 2018 |
| Předmět: |
Adult
Male medicine.medical_specialty Pediatrics Bipolar Disorder Long term treatment Observation period Appropriate use Secondary Care Disease course 03 medical and health sciences 0302 clinical medicine Naturalistic observation Recurrence medicine Humans Recurrences Prospective Studies Bipolar disorder Relapse Psychiatry Predictors Course of illness Reproducibility of Results Middle Aged Prognosis medicine.disease Long-Term Care Antidepressive Agents Bipolar disorder I 030227 psychiatry Bipolar disorder II Psychiatry and Mental health Clinical Psychology Mixed states Disease Progression Treatment strategy Female Psychology Psychiatry and Mental Health 030217 neurology & neurosurgery Follow-Up Studies |
| Zdroj: | Journal of Affective Disorders. 225:123-128 |
| ISSN: | 0165-0327 |
| Popis: | Background Despite the large number of treatments available for bipolar disorder (BD), more than one half of patients have a recurrence within 2 years, and over 90% experience at least one additional affective episode during their lifetime. Methods The aim of this study was to test the impact of a number of demographic and clinical features on the risk to recurrence in a real- word representative sample of 266 outpatients with BD-I or II treated in a naturalistic setting during a 4-years-follow-up period. Results We found that the number of episodes per year after study entry, compared to the number of episodes per year before study entry,significantly decreased and that about one third of patients had no recurrences during the observation period. The length of follow-up and the number of previous episodes, mainly depressive, predicted the risk of recurrence, while female gender, higher age at intake, and a higher frequency of past mixed episodes predicted a higher frequency of recurrences. Limitations The study had some limitations to consider: i.e. the risk of poor reliability of information on the previous course of illness or the naturalistic treatment during the follow-up. Conclusions Our study suggests that (a) an evidence-based long-term treatment, with regular follow-up visits could improve the course of disease and prognosis; (b) clinicians should carefully consider the presence of a high number of mixed episodes, to provide more targeted treatment strategies; (c) an appropriate use of antidepressants in selected patients did not worsen the course of illness. |
| Databáze: | OpenAIRE |
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