Duration of untreated illness and bipolar disorder: time for a new definition? Results from a cross-sectional study
Background: We primarily aimed to explore the associations between duration of untreated illness (DUI), treatment response, and functioning in a cohort of patients with bipolar disorder (BD). Methods: 261 participants with BD were recruited. DUI was defined as months from the first affective episode...
| Autores: | , , , , , , , , , , |
|---|---|
| Formato: | artículo |
| Estado: | Versión publicada |
| Fecha de publicación: | 2021 |
| País: | España |
| Recursos: | Universidad de Barcelona |
| Repositorio: | Dipòsit Digital de la UB |
| OAI Identifier: | oai:diposit.ub.edu:2445/185217 |
| Acesso em linha: | https://hdl.handle.net/2445/185217 |
| Access Level: | acceso abierto |
| Palavra-chave: | Trastorn bipolar Cognició Psicodiagnòstic Trastorns afectius Manic-depressive illness Cognition Psychodiagnostics Affective disorders |
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Duration of untreated illness and bipolar disorder: time for a new definition? Results from a cross-sectional studyFico, GiovannaAnmella, GerardGómez-Ramiro, MartaMiquel, Carlota deHidalgo Mazzei, DiegoManchia, MirkoAlda, MartinGonzález-Pinto, AnaCarvalho, André F.Vieta i Pascual, Eduard, 1963-Murru, AndreaTrastorn bipolarCognicióPsicodiagnòsticTrastorns afectiusManic-depressive illnessCognitionPsychodiagnosticsAffective disordersBackground: We primarily aimed to explore the associations between duration of untreated illness (DUI), treatment response, and functioning in a cohort of patients with bipolar disorder (BD). Methods: 261 participants with BD were recruited. DUI was defined as months from the first affective episode to the start of a mood-stabilizer. The functioning assessment short test (FAST) scores and treatment response scores for lithium, valproate, or lamotrigine according to the Alda Scale Total Score (TS) were compared between patients with short (<24 months) or long DUI. Differences in FAST scores among good (GR; TS≥7), poor (PR; TS=2-6), or non-responders (NR; TS<2) to each mood-stabilizer were analyzed. Linear regression was computed using the FAST global score as the dependent variable. Results: DUI and FAST scores showed no statistically significant correlation. Patients with a longer DUI showed poorer response to lithium (Z=-3.196; p<0.001), but not to valproate or lamotrigine. Response to lithium (β=-1.814; p<0.001), number of hospitalizations (β=0.237; p<0.001), and illness duration (β=0.160; p=0.028) were associated with FAST total scores. GR to lithium was associated with better global functioning compared to PR or NR [H=27.631; p<0.001]. Limitations: The retrospective design could expose our data to a recall bias. Also, only few patients were on valproate or lamotrigine treatment. Conclusions: Poor functioning in BD could be the result of multiple affective relapses, rather than a direct effect of DUI. A timely diagnosis with subsequent effective prophylactic treatment, such as lithium, may prevent poor functional outcomes in real-world patients with BD.Elsevier B.V.2021info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://hdl.handle.net/2445/185217Articles publicats en revistes (Medicina)reponame:Dipòsit Digital de la UBinstname:Universidad de BarcelonaInglésReproducció del document publicat a: https://doi.org/10.1016/j.jad.2021.07.062Journal of Affective Disorders, 2021, vol. 294, p. 513-520https://doi.org/10.1016/j.jad.2021.07.062cc-by (c) Fico, Giovanna et al, 2021https://creativecommons.org/licenses/by/4.0/info:eu-repo/semantics/openAccessoai:diposit.ub.edu:2445/1852172026-05-27T06:46:51Z |
| dc.title.none.fl_str_mv |
Duration of untreated illness and bipolar disorder: time for a new definition? Results from a cross-sectional study |
| title |
Duration of untreated illness and bipolar disorder: time for a new definition? Results from a cross-sectional study |
| spellingShingle |
Duration of untreated illness and bipolar disorder: time for a new definition? Results from a cross-sectional study Fico, Giovanna Trastorn bipolar Cognició Psicodiagnòstic Trastorns afectius Manic-depressive illness Cognition Psychodiagnostics Affective disorders |
| title_short |
Duration of untreated illness and bipolar disorder: time for a new definition? Results from a cross-sectional study |
| title_full |
Duration of untreated illness and bipolar disorder: time for a new definition? Results from a cross-sectional study |
| title_fullStr |
Duration of untreated illness and bipolar disorder: time for a new definition? Results from a cross-sectional study |
| title_full_unstemmed |
Duration of untreated illness and bipolar disorder: time for a new definition? Results from a cross-sectional study |
| title_sort |
Duration of untreated illness and bipolar disorder: time for a new definition? Results from a cross-sectional study |
| dc.creator.none.fl_str_mv |
Fico, Giovanna Anmella, Gerard Gómez-Ramiro, Marta Miquel, Carlota de Hidalgo Mazzei, Diego Manchia, Mirko Alda, Martin González-Pinto, Ana Carvalho, André F. Vieta i Pascual, Eduard, 1963- Murru, Andrea |
| author |
Fico, Giovanna |
| author_facet |
Fico, Giovanna Anmella, Gerard Gómez-Ramiro, Marta Miquel, Carlota de Hidalgo Mazzei, Diego Manchia, Mirko Alda, Martin González-Pinto, Ana Carvalho, André F. Vieta i Pascual, Eduard, 1963- Murru, Andrea |
| author_role |
author |
| author2 |
Anmella, Gerard Gómez-Ramiro, Marta Miquel, Carlota de Hidalgo Mazzei, Diego Manchia, Mirko Alda, Martin González-Pinto, Ana Carvalho, André F. Vieta i Pascual, Eduard, 1963- Murru, Andrea |
| author2_role |
author author author author author author author author author author |
| dc.subject.none.fl_str_mv |
Trastorn bipolar Cognició Psicodiagnòstic Trastorns afectius Manic-depressive illness Cognition Psychodiagnostics Affective disorders |
| topic |
Trastorn bipolar Cognició Psicodiagnòstic Trastorns afectius Manic-depressive illness Cognition Psychodiagnostics Affective disorders |
| description |
Background: We primarily aimed to explore the associations between duration of untreated illness (DUI), treatment response, and functioning in a cohort of patients with bipolar disorder (BD). Methods: 261 participants with BD were recruited. DUI was defined as months from the first affective episode to the start of a mood-stabilizer. The functioning assessment short test (FAST) scores and treatment response scores for lithium, valproate, or lamotrigine according to the Alda Scale Total Score (TS) were compared between patients with short (<24 months) or long DUI. Differences in FAST scores among good (GR; TS≥7), poor (PR; TS=2-6), or non-responders (NR; TS<2) to each mood-stabilizer were analyzed. Linear regression was computed using the FAST global score as the dependent variable. Results: DUI and FAST scores showed no statistically significant correlation. Patients with a longer DUI showed poorer response to lithium (Z=-3.196; p<0.001), but not to valproate or lamotrigine. Response to lithium (β=-1.814; p<0.001), number of hospitalizations (β=0.237; p<0.001), and illness duration (β=0.160; p=0.028) were associated with FAST total scores. GR to lithium was associated with better global functioning compared to PR or NR [H=27.631; p<0.001]. Limitations: The retrospective design could expose our data to a recall bias. Also, only few patients were on valproate or lamotrigine treatment. Conclusions: Poor functioning in BD could be the result of multiple affective relapses, rather than a direct effect of DUI. A timely diagnosis with subsequent effective prophylactic treatment, such as lithium, may prevent poor functional outcomes in real-world patients with BD. |
| publishDate |
2021 |
| dc.date.none.fl_str_mv |
2021 |
| dc.type.none.fl_str_mv |
info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion |
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article |
| status_str |
publishedVersion |
| dc.identifier.none.fl_str_mv |
https://hdl.handle.net/2445/185217 |
| url |
https://hdl.handle.net/2445/185217 |
| dc.language.none.fl_str_mv |
Inglés |
| language_invalid_str_mv |
Inglés |
| dc.relation.none.fl_str_mv |
Reproducció del document publicat a: https://doi.org/10.1016/j.jad.2021.07.062 Journal of Affective Disorders, 2021, vol. 294, p. 513-520 https://doi.org/10.1016/j.jad.2021.07.062 |
| dc.rights.none.fl_str_mv |
cc-by (c) Fico, Giovanna et al, 2021 https://creativecommons.org/licenses/by/4.0/ info:eu-repo/semantics/openAccess |
| rights_invalid_str_mv |
cc-by (c) Fico, Giovanna et al, 2021 https://creativecommons.org/licenses/by/4.0/ |
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openAccess |
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application/pdf |
| dc.publisher.none.fl_str_mv |
Elsevier B.V. |
| publisher.none.fl_str_mv |
Elsevier B.V. |
| dc.source.none.fl_str_mv |
Articles publicats en revistes (Medicina) reponame:Dipòsit Digital de la UB instname:Universidad de Barcelona |
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Universidad de Barcelona |
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Dipòsit Digital de la UB |
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Dipòsit Digital de la UB |
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