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...

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Autores: 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
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2021
País:España
Institución:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
Repositorio:Recercat. Dipósit de la Recerca de Catalunya
OAI Identifier:oai:recercat.cat:2445/185217
Acceso en línea:https://hdl.handle.net/2445/185217
Access Level:acceso abierto
Palabra clave:Trastorn bipolar
Cognició
Psicodiagnòstic
Trastorns afectius
Manic-depressive illness
Cognition
Psychodiagnostics
Affective disorders
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spelling 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.2022202220212022info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersion8 p.application/pdfapplication/pdfhttps://hdl.handle.net/2445/185217Articles publicats en revistes (Medicina)reponame:Recercat. Dipósit de la Recerca de Catalunyainstname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)InglésReproducció 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:recercat.cat:2445/1852172026-05-29T05:05:01Z
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
2022
2022
2022
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format 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/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv 8 p.
application/pdf
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:Recercat. Dipósit de la Recerca de Catalunya
instname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
instname_str Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
reponame_str Recercat. Dipósit de la Recerca de Catalunya
collection Recercat. Dipósit de la Recerca de Catalunya
repository.name.fl_str_mv
repository.mail.fl_str_mv
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