Predictors of relapse or recurrence in bipolar I disorder
Predictors of relapse or recurrence in bipolar I disorder
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DOI：
10.1016/j.jad.2011.09.051
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发表时间：
2012-02-01
影响因子：
6.6
通讯作者：
Tohen, Mauricio
中科院分区：
文献类型：
--
作者：
Degenhardt, Elisabeth K.;Gatz, Jennifer L.;Tohen, Mauricio
目的：双相情感障碍是一个主要的公共卫生问题，尽管治疗，但其特征是反复发作的躁狂、抑郁或混合状态。预防复发或复发是疾病管理的主要治疗目标。本研究的目的是确定奥氮平、锂、双丙戊酸或奥氮平加双丙戊酸/锂治疗双相I型双相障碍患者复发/复发的预测因素。方法：四项研究奥氮平与安慰剂和活性对照物（锂、双丙戊酸、奥氮平加双丙戊酸/锂）治疗双相I型障碍疗效的临床试验的数据汇总进行分析。药物治疗后缓解并进入44 - 72周随机双盲维持期的患者被纳入研究。使用Cox比例风险模型和Kaplan-Meier分析来确定合并数据和每个治疗组内复发/复发的预测因子。结果：本研究共纳入929例符合缓解标准并继续维持治疗的患者，其中427例（46.0%）患者在随访期间出现症状性复发/复发。汉米尔顿抑郁评定量表（HAMD-21）总分共21项
Objectives: Bipolar disorder represents a major public health concern and, despite treatment, is characterized by recurring episodes of mania, depression, or mixed states. Prevention of relapse or recurrence is a primary treatment objective in the management of the disorder. The objective of the current study was to identify predictors of relapse/recurrence in patients with bipolar I disorder treated with olanzapine, lithium, divalproex, or olanzapine plus divalproex/lithium.Methods: Data from four clinical trials studying the efficacy of olanzapine compared to placebo and active comparators (lithium, divalproex, olanzapine plus divalproex/lithium) for bipolar I disorder were pooled for this analysis. Patients achieving remission after pharmacological treatment and entering randomized double-blind maintenance phase for 44 to 72 weeks were included. Cox Proportional Hazard models and Kaplan-Meier analyses were used to determine predictors of relapse/recurrence for the pooled data and within each treatment group.Results: A total of 929 patients meeting the criteria for remission and followed by maintenance treatment were included in this analysis, and 427 patients (46.0%) experienced symptomatic relapse/recurrence during the follow-up period. A 21-item Hamilton Depression Rating Scale (HAMD-21) total score