Journals / Anadolu Psikiyatri Dergisi / 2014 / Cilt: 15 - Sayı: 4

A cross-sectional analysis of patient characteristics and practice patterns in the management of bipolar disorder across Turkey

Türkiye'de bipolar bozukluğun ele alınmasında pratik uygulamalar ve hasta özelliklerinin kesitsel incelenmesi

Pages
304–312
DOI
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AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

Lithium, sodium valproate and atypical antipsychotics were more commonly used drugs in the treatment of BD in Turkey.

📌 3 Key Takeaways

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Objective & Hypothesis:Objective: Bipolar disorder (BD) is one of the leading causes of disability among medical and psychiatric disorders associated with prevalent, chronic, severe and highly disabling characteristics.
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Key Findings & Data:Method: This multi-center cross-sectional study involving 1001 patients diagnosed with using DSM-IV criteria was conducted prospectively at 31 outpatient psychiatry clinics for 12 months.
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Conclusion & Impact:Lithium, sodium valproate and atypical antipsychotics were more commonly used drugs in the treatment of BD in Turkey.
🔬Design:Survey & Empirical Study
📍Scope:Comprehensive Sample
⚙️Variables:Domain Parameters

Abstract

Objective: Bipolar disorder (BD) is one of the leading causes of disability among medical and psychiatric disorders associated with prevalent, chronic, severe and highly disabling characteristics. This study was designed to identify clinical characteristics and practice patterns in the management of outpatients with BD across Turkey. Method: This multi-center cross-sectional study involving 1001 patients diagnosed with using DSM-IV criteria was conducted prospectively at 31 outpatient psychiatry clinics for 12 months. Patient demographics, clinical features, family history, comorbid psychiatric disorders, and the treatment modalities were assessed by means of semistructured questionnaire. Results: Age at the onset of symptoms was 26.7±9.8 years, age at diagnosis was 28.9±10.4 years, and the time interval between them was 2.2±4.7 years. Misdiagnosis prior to current diagnosis was evident in 40.3% of bipolar patients. The most common type of first episode was mania (57.1%) and depression (34.5%). Comorbid psychiatric illness was identified in 12.0% of patients. Only 10% of patients were receiving monotherapy. The most commonly prescribed drugs for depressive, manic and mixed episodes were lithium, sodium valproate and quetiapine, respectively. Conclusion: The time interval between onset of symptoms and the initial diagnosis in Turkish sample was quite shorter than reported in the literature. The misdiagnosis rate in the present study and recent studies were similar. A low comorbidity rate appears to indicate a lower prevalence of comorbid disorders in BD in Turkish sample. Lithium, sodium valproate and atypical antipsychotics were more commonly used drugs in the treatment of BD in Turkey.

Özet

Amaç: Bipolar bozukluk (BB), tıbbi ve ruhsal bozukluklar arasında önemli yeti yimine yol açan yaygın, kronik bir bozukluktur. Bu çalışma Türkiye"de ayaktan izlenen hastaların klinik özellikleri ve pratik örüntülerini belirlemek amacıyla planlanmıştır. Yöntem: Çok merkezli kesitsel olan bu çalışmaya 12 ay içinde ayaktan psikiyatri hizmetleri veren 31 kliniğe başvuran DSM-IV ölçetlerine göre tanı konan 1001 hasta alınmıştır. Hastaların demografik, klinik özellik, aile öyküsü, eşlik eden ruhsal bozukluklar ve tedavi modaliteleri yarı yapılandırılmış bir anketle değerlendirilmiştir. Bulgular: Hastalığın başlangıç yaşı 26.7±9.8, tanı konan yaş 28.9±10.4 ve ikisinin arasındaki süre 2.2±4.7 yıldır. Şu anki tanıdan önce yanlış tanı konma oranı %40.3"dür. En sık ilk nöbet tipi mani (%57.1) ve depresyondur (%34.5). Eşlik eden ruhsal hastalık hastaların %12"sinde saptanmıştır. Hastaların yalnız %10"u monoterapi almaktadır. En sık reçete edilen ilaçlar depresif, manik ve karma nöbetler için sırasıyla lityum, sodyum valproat ve ketiyapindir. Sonuç: Türkiye"deki örneklemde belirtilerin başlangıcı ve ilk tanı alma arasındaki süre daha once yapılan çalışmalarda bildirilen sürelerden kısadır. Yanlış tanı alma oranları daha önce yapılan çalışmalarla benzerdir. Eşlik eden ruhsal hastalık oranının düşük çıkması Türk toplumu örnekleminde eşlik eden ruhsal bozukluk yaygınlığının düşük olması ile ilişkilidir. Lityum, sodyum valproat ve atipik antipsikotikler Türkiye"de en sık kullanılan ilaç tedavilerdir.

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Cite This Article

BİLİCİ, M., KESEBİR, S., KARAGÜZEL, E. Ö., YANARTAŞ, Ö., İŞİTMEZ, S. (2014). A cross-sectional analysis of patient characteristics and practice patterns in the management of bipolar disorder across Turkey. Anadolu Psikiyatri Dergisi, Cilt: 15 - Sayı: 4, 304–312. https://ajindex.com/articles/355820

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References (13)

  1. Belmaker RH. Medical progress: Bipolar disor- der. N. Engl. J. Med 2004; 351:476-486.
  2. Murray CJ, Lopez AD. The utility of DALYs for public health policy and research: a reply. Bull World Health Organ 1999; 75:377-381.
  3. Akiskal HS, Bourgeois ML, Angst J, Post R, Möl- ler HJ, Hirschfeld R. Re-evaluating the preva- lence of and diagnostic composition within the broad clinical spectrum of bipolar disorder. J Affect Disord 2000; 59:2-30.
  4. Robb JC, Cooke RG, Devins G.M, Young LT, Joffe RT. Quality of life and lifestyle disruption in euthymic bipolar disorder. J Psychiatr Res 1997; 3:509-517.
  5. Vornik LA, Hirschfeld RMA. Bipolar disorder: quality of life and the impact of atypical anti- psychotics. Am J Manag Care 2005; 11(Supp.1): 275-280.
  6. Bryant-Comstock L, Stender M, Devercelli G. Health care utilization and cost among privately insured patients with bipolar I disorder. Bipolar Disord 2002; 4:398-405.
  7. Hirschfeld RM, Cass AR, Holt DC, Carlson CA. Screening for bipolar disorder in patients treated for depression in a family medicine clinic. J Am Board Fam Pract 2005; 18:233-239.
  8. Lish JD, Dime-Meenan S, Whybrow PC, Price RA, Hirschfield RM. The National Depressive and Manic-Depressive Association (DMDA) survey of bipolar members. J Affect Disord 1994; 31:281-294.
  9. Emilien G, Septien L, Brisard C, Corruble E, Bourin M. Bipolar disorder: how far are we from a rigorous definition and effective management? Prog Neuropsychopharmacol Biol Psychiatry 2007; 31:975-996. American Psychiatric Association. Part A: Treat- ment recommendations for patients with bipolar disorder. Am J Psychiatry 2002; 159(Suppl.4):4- 15. Keck PE Jr, Perlis RH, Otto MW, Carpenter D, Ross R, Docherty JP. The expert consensus guideline series treatment of bipolar disorder. Postgrad Med Special Report 2004; 12:1-120.
  10. Lim PZ, Tunis SL, Edell WS. Medication pre- scribing patterns for patients with bipolar I disor- der in hospital settings: adherence to published practice guidelines. Bipolar Disord 2001; 3:165- 173. Almeida OP, Fenner S. Bipolar disorder: similari- ties and differences between patients with illness onset before and after 65 years of age. Int Psychogeriatr 2002; 14:311-322.
  11. Angst J, Sellaro R. Historical perspectives and natural history of bipolar disorder. Biol Psychiatry 2000; 48:445-457.
  12. Angst J, Gamma A, Lewinsohn P. The evolving epidemiology of bipolar disorder. World Psychiat- ry 2002; 1:146-148.
  13. Goodwin FK, Jamison KR. Manic-depressive Ill- ness. New York: Oxford University Press, 19