RESUMO
OBJECTIVE: The aim of the present study was to assess the association between previous suicide attempts and functional impairment among euthymic patients with bipolar disorder (BD). METHODS: Seventy-one Diagnostic Statistical Manual IV (DSM-IV) patients with BD and 61 healthy volunteers were recruited from the Bipolar Disorder Program at the Clinic Hospital of Barcelona. Patients with (n = 36, 50.7%) and without (n = 35, 49.3%) previous suicide attempts were assessed using the Structured Clinical Interview for DSM-IV-TR (SCID-P). Previous suicide attempts were carefully investigated by means of patient and caregiver interview and by a standard structured interview from the protocol of our BD Program. The Functioning Assessment Short Test (FAST) was employed to assess functional impairment. RESULTS: Euthymic patients with previous suicide attempts showed functional impairment, particularly in occupational (F = 30.39; p = 0.001) and cognitive functioning (F = 18.43; p = 0.001). In addition, family history of psychiatric illness (χ2: 6.49; degrees of freedom (df) = 2;132; p = 0.010), family history of affective disorders (χ2 = 5.57; p = 0.017), psychotic symptoms (χ2 = 5.88; p = 0.014) and axis II comorbidity were associated with previous suicide attempts (χ2 = 5.16; p = 0.021). CONCLUSION: Bipolar patients with previous suicide attempts had lower overall functioning than patients who did not attempt suicide. Previous suicide attempts were particularly associated with the occupational and cognitive domains of functioning.
RESUMO
Data from a published double-blind randomized trial comparing olanzapine versus haloperidol in acute mania were used to address the response and tolerability of Latin American patients. Primary efficacy end point was the remission rate (Young Mania Rating Scale score Assuntos
Transtorno Bipolar/tratamento farmacológico
, Hispânico ou Latino/psicologia
, População Branca/psicologia
, Doença Aguda
, Idoso
, Antipsicóticos/administração & dosagem
, Antipsicóticos/efeitos adversos
, Antipsicóticos/uso terapêutico
, Benzodiazepinas/administração & dosagem
, Benzodiazepinas/efeitos adversos
, Benzodiazepinas/uso terapêutico
, Transtorno Bipolar/etnologia
, Transtorno Bipolar/psicologia
, Colesterol/sangue
, Manual Diagnóstico e Estatístico de Transtornos Mentais
, Método Duplo-Cego
, Jejum/sangue
, Feminino
, Haloperidol/administração & dosagem
, Haloperidol/efeitos adversos
, Haloperidol/uso terapêutico
, Hospitalização/estatística & dados numéricos
, Humanos
, Masculino
, Pessoa de Meia-Idade
, Olanzapina
, Indução de Remissão
, Fatores de Tempo
, Resultado do Tratamento
, Aumento de Peso/efeitos dos fármacos
RESUMO
RATIONALE: There are very few data as to the social and occupational adaptation of patients with bipolar disorder in Spain and even less is known about the resource use they generate. OBJECTIVE: To determine the functional status and healthcare resource use of the Spanish sample of the pan European EMBLEM (European Mania in Bipolar Longotudinal Evaluation of Medication) study of bipolar patients in manic or mixed phase. METHOD: The EMBLEM study recruited 3536 patients, 312 of whom (8.82%) were enrolled in Spain. Patients had to be adults with a diagnosis of bipolar disorder who were initiating at the discretion of their treating psychiatrist oral treatment for an acute manic phase. They were evaluated using the Spanish versions of rating scales for the severity of mania (Young Mania Rating Scale), bipolar disorder (CGI BD) for mania, depression and hallucinations delusions, and depression (HAMD 5 item version of the Hamilton Scale); the Life Chart Method (LCM) and 2 items of the SLICE of LIFE were used to evaluate functioning. Information was collected on healthcare resource utilization during the preceding year. RESULTS: Sixty three percent of the patients presented with moderate to very severe work related difficulties in the year preceding his her manic episode. Forty percent of the patients failed to comply either totally or partly with their prescribed treatment. Subjects required an average of 1.5 hospitalizations during the year prior to enrollment, with a mean stay of approximately 10 days, and between 7 and 8 outpatient visits per year.