Patterns of changes in bipolar depressive symptoms revealed by trajectory analysis among 482 patients with bipolar disorder

Autor: Michael E. Thase, Louisa G. Sylvia, Andrew A. Nierenberg, Holger J. Sørensen, Richard C. Shelton, Susan L. McElroy, Mauricio Tohen, Edward S. Friedman, Ole Köhler-Forsberg, Melvin G. McInnis, Keming Gao, Charles L. Bowden, William V. Bobo, Trine Madsen, Masoud Kamali, James H. Kocsis, Joseph R. Calabrese, Ida Behrendt-Møller, Terence A. Ketter, Thilo Deckersbach, Noreen A. Reilly-Harrington
Rok vydání: 2018
Předmět:
Male
Bipolar Disorder
Lithium (medication)
Bipolar Disorder/diagnosis
Antidepressive Agents/therapeutic use
0302 clinical medicine
depressive symptoms
Prevalence
ANXIETY
PREDICTORS
Depression (differential diagnoses)
bipolar disorder
Depression
Quetiapine Fumarate/therapeutic use
Prognosis
CHOICE
Antidepressive Agents
Psychiatry and Mental health
Treatment Outcome
ADOLESCENCE
Lithium Compounds
Female
Drug Monitoring
OUTPATIENTS
Drug Monitoring/methods
medicine.drug
Adult
medicine.medical_specialty
Randomization
PRIMARY-CARE PATIENTS
03 medical and health sciences
Quetiapine Fumarate
Rating scale
Depression/diagnosis
Internal medicine
medicine
trajectories
Humans
Bipolar disorder
QUETIAPINE
Biological Psychiatry
Depressive symptoms
TREATMENT RESPONSE
Lithium Compounds/therapeutic use
Psychiatric Status Rating Scales
business.industry
ANTIDEPRESSANT
NATURAL-HISTORY
medicine.disease
030227 psychiatry
Clinical trial
Quetiapine
growth mixture modeling
business
030217 neurology & neurosurgery
Zdroj: Köhler-Forsberg, O 2018, ' Patterns of changes in bipolar depressive symptoms revealed by trajectory analysis among 482 patients with bipolar disorder. ' Bipolar Disorders . https://doi.org/10.1111/bdi.12715
Behrendt-Møller, I, Madsen, T, Sørensen, H J, Sylvia, L, Friedman, E S, Shelton, R C, Bowden, C L, Calabrese, J R, McElroy, S L, Ketter, T A, Reilly-Harrington, N A, Gao, K, Thase, M, V Bobo, W, Tohen, M, McInnis, M, Kamali, M, Kocsis, J H, Deckersbach, T, Köhler-Forsberg, O & Nierenberg, A A 2019, ' Patterns of changes in bipolar depressive symptoms revealed by trajectory analysis among 482 patients with bipolar disorder ', Bipolar disorders, vol. 21, no. 4, pp. 350-360 . https://doi.org/10.1111/bdi.12715
ISSN: 1399-5618
Popis: INTRODUCTION: Depressive episodes are often prevalent among patients with bipolar disorder, but little is known regarding the differential patterns of development over time. We aimed to determine and characterize trajectories of depressive symptoms among adults with bipolar disorder during 6 months of systematic treatment.METHODS: The pragmatic clinical trial, Bipolar Clinical Health Outcomes Initiative in Comparative Effectiveness (CHOICE), randomized 482 outpatients with bipolar disorder to lithium or quetiapine. Depressive symptoms were rated at up to 9 visits using the Montgomery-Asberg Depression Rating Scale (MADRS). Growth mixture modeling was utilized to identify trajectories and multinomial regression analysis estimated associations with potential predictors.RESULTS: Four distinct trajectories of depressive symptoms were identified. The responding class (60.3%) with a rapid reduction and subsequent low level; the partial-responding class (18.4%) with an initial reduction followed by an increase during the remaining weeks; the fluctuating class (11.6%) with a fluctuation in depressive symptoms; and the non-responding class (9.7%) with sustained moderate-severe depressive symptoms. Bipolar type I predicted membership of the non-responding class and randomization to quetiapine predicted membership of either the responding or the non-responding class.CONCLUSION: Approximately 30% experienced a partial or fluctuating course, and almost 10% had a chronic course with moderate-severe depression during 6 months. Patients diagnosed with bipolar type 1 had higher risk of being categorized into a class with a worse outcome. While no differences in average overall outcomes occurred between the lithium and quetiapine groups, trajectory analysis revealed that the lithium group had more variable courses.
Databáze: OpenAIRE
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