Association between duration of untreated bipolar disorder and clinical outcome: data from a Brazilian sample
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Citações na Scopus
22
Tipo de produção
article
Data de publicação
2016
Título da Revista
ISSN da Revista
Título do Volume
Editora
ASSOC BRASILEIRA PSIQUIATRIA
Citação
REVISTA BRASILEIRA DE PSIQUIATRIA, v.38, n.1, p.6-10, 2016
Resumo
Objective: Bipolar disorder (BD) is often left untreated for long periods, and this delay in treatment correlates with unfavorable prognosis. The present study sought to assess the magnitude of duration of untreated bipolar disorder (DUB) in Brazil. We hypothesized that DUB would be longer in Brazil than in developed countries, and would be associated with poor clinical outcomes. Methods: One hundred and fifty-two psychiatric outpatients were evaluated for BD diagnosis, demographics, DUB, and clinical outcomes. Results: The mean age and mean DUB were, respectively, 38.9 +/- 10.8 and 10.4 +/- 9.8 years. An extended DUB was associated with early onset of BD (p < 0.001), depression as first mood episode (p = 0.04), and presence of BD in a first-degree relative (p = 0.012). Additionally, a longer DUB was associated with poorer clinical outcomes, such as elevated rates of rapid cycling (p = 0.004) and anxiety disorders (p = 0.016), as well as lower levels of current full remission (p = 0.021). Conclusion: As DUB may be a modifiable variable, better medical education regarding mental health, more structured medical services, and population-wide psychoeducation might reduce the time between onset and proper management of BD, thus improving outcome.
Palavras-chave
Community mental health, mood disorders, bipolar disorder, outpatient psychiatry, chronic psychiatric illness
Referências
- Gentil V, 2007, REV BRAS PSIQUIATR, V29, P193, DOI 10.1590/S1516-44462007000200025
- Chisholm D, 2005, BRIT J PSYCHIAT, V187, P559, DOI 10.1192/bjp.187.6.559
- Altamura AC, 2010, INT CLIN PSYCHOPHARM, V25, P172, DOI 10.1097/YIC.0b013e3283384c74
- Yatham LN, 2013, BIPOLAR DISORD, V15, P1, DOI 10.1111/bdi.12025
- Reed C, 2010, EUR PSYCHIAT, V25, P338, DOI 10.1016/j.eurpsy.2010.01.001
- Yatham LN, 2005, BIPOLAR DISORD, V7, P5
- Leboyer M, 2010, J CLIN PSYCHIAT, V71, P1689, DOI 10.4088/JCP.10m06347yel
- McCraw S, 2014, J AFFECT DISORDERS, V168, P422, DOI 10.1016/j.jad.2014.07.025
- Link BG, 2001, ANNU REV SOCIOL, V27, P363, DOI 10.1146/annurev.soc.27.1.363
- Altamura AC, 2010, EUR ARCH PSY CLIN N, V260, P385, DOI 10.1007/s00406-009-0085-2
- Melle I, 2008, ARCH GEN PSYCHIAT, V65, P634, DOI 10.1001/archpsyc.65.6.634
- Drancourt N, 2013, ACTA PSYCHIAT SCAND, V127, P136, DOI 10.1111/j.1600-0447.2012.01917.x
- Kohn R, 2004, B WORLD HEALTH ORGAN, V82, P858
- Bruckner TA, 2011, B WORLD HEALTH ORGAN, V89, P184, DOI 10.2471/BLT.10.082784
- Kilsztajn S, 2008, CAD SAUDE PUBLICA, V24, P2354, DOI 10.1590/S0102-311X2008001000016
- Perlick DA, 2001, PSYCHIATR SERV, V52, P1627, DOI 10.1176/appi.ps.52.12.1627
- Murray CJL, 2013, JAMA-J AM MED ASSOC, V310, P591, DOI 10.1001/jama.2013.13805
- Peele PB, 2003, AM J PSYCHIAT, V160, P1286, DOI 10.1176/appi.ajp.160.7.1286
- Berk M, 2010, NEUROSCI BIOBEHAV R, V35, P804
- Center for Diseases Control and Prevention (CDC), 2013, BURD MENT ILLN
- Del-Ben Cristina Marta, 2001, Revista Brasileira de Psiquiatria, V23, P156, DOI 10.1590/S1516-44462001000300008
- Henry Chantal, 2013, Int J Bipolar Disord, V1, P2, DOI 10.1186/2194-7511-1-2
- Leboyer M, 2010, J AFFECT DISORDERS, V141, P1
- Michalak Erin, 2011, Chronic Illn, V7, P209, DOI 10.1177/1742395310395959
- The World Bank, 2015, BRAZ OV