Differential prevalence and demographic and clinical correlates of antidepressant use in American bipolar I versus bipolar II disorder patients.

Differential prevalence and demographic and clinical correlates of antidepressant use in American bipolar I versus bipolar II disorder patients.
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美国 I 型双相情感障碍患者与 II 型双相情感障碍患者抗抑郁药物使用的差异患病率以及人口统计学和临床​​相关性。

DOI:
10.1016/j.jad.2018.02.091
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发表时间:
2018
影响因子:
6.6
通讯作者:
Miller,Shefali
Miller,Shefali
中科院分区:
医学2区
文献类型:
--
作者:
Hooshmand,Farnaz;Do,Dennis;Shah,Saloni;Gershon,Anda;Park,DongYeon;Kim,Hyun;Yuen,LauraD;Dell'Osso,Bernardo;Wang,PoW;Ketter,TerenceA;Miller,Shefali

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目的抗抑郁药在双相情感障碍(BD)中的使用存在争议,因为疗效/精神耐受性可疑。我们评估了BD患者基线抗抑郁药使用的人口统计学/临床特征。2000-2011年期间,斯坦福大学双相临床的503例BD I和BD II门诊患者的基线抗抑郁药使用的患病率和相关性采用BD系统治疗增强计划(STEP-BD)情感障碍评估进行了评估。BD II组高于BD I组(46.9% vs 30.5%,p = 0.0002)。与非抗抑郁药使用者相比,BD I和BD II抗抑郁药使用者的复合药物治疗(≥ 4种情绪稳定剂、抗精神病药和/或抗抑郁药)和其他精神药物使用率更高。在心境正常时,BD II的抗抑郁药使用高于BD I(44.0% vs. 28.0%)和亚综合征症状(56.1%对28.6%),但不是抑郁症或情绪elevation. LimitationsAmericantertiaryBD诊所转诊样本接受开放式自然主义治疗。并且与BD I和BD II患者的疾病严重程度升高的标志物相关。需要进一步的研究来调查这些复杂的关系。
AimsAntidepressant use is controversial in bipolar disorder (BD) due to questionable efficacy/psychiatric tolerability. We assessed demographic/clinical characteristics of baseline antidepressant use in BD patients.MethodsPrevalence and correlates of baseline antidepressant use in 503 BD I and BD II outpatients referred to the Stanford Bipolar Clinic during 2000–2011 were assessed with the Systematic Treatment Enhancement Program for BD (STEP-BD) Affective Disorders Evaluation.ResultsAntidepressant use was 39.0%, overall, and was higher in BD II versus BD I (46.9% versus 30.5%, p = 0.0002). Both BD I and BD II antidepressant compared to non-antidepressant users had higher rates of complex pharmacotherapy (≥ 4 mood stabilizers, antipsychotics, and/or antidepressants) and use of other psychotropics. Antidepressant use in BD II versus BD I was higher during euthymia (44.0% vs. 28.0%) and subsyndromal symptoms (56.1% vs. 28.6%), but not depression or mood elevation.LimitationsAmerican tertiary BD clinic referral sample receiving open naturalistic treatment.ConclusionsIn our sample, antidepressant use was higher in BD II versus BD I patients, and was associated with markers of heightened illness severity in both BD I and BD II patients. Additional research is warranted to investigate these complex relationships.
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