Gazalle Fernando Kratz, Hallal Pedro Curi, Tramontina Juliana, Rosa Adriane Ribeiro, Andreazza Ana Cristina, Zanatto Vanessa, Santin Aida, Kapczinski Flávio, Ceresér Keila Maria
Post-graduate Psychiatry Program, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.
Braz J Psychiatry. 2007 Mar;29(1):35-8.
The aim of this study was to assess the association between suicide attempts and the use of multiple drugs in patients with bipolar disorder.
One hundred sixty-nine bipolar disorder outpatients diagnosed using the DSM-IV Structured Clinical Interview were included. Demographic and socioeconomic data, number of medications currently in use, history of suicide attempts, number of years undiagnosed, age of onset and current psychiatric co-morbidities were assessed using a structured questionnaire and DSM-IV criteria. The main outcome measure was the number of psychotropic drugs currently in use.
Approximately half of all patients (48.5%) presented a history of suicide attempt; 84% were using more than one medication, and 19% were using more than three drugs. The most frequent combinations of drugs used by these patients were: lithium + valproate (17%); lithium + antipsychotics (10%); lithium + valproate + antipsychotics (9%); and antidepressants + any drug (6%). The number of suicide attempts was associated with the use of multiple drugs.
Our findings support the notion that the use of combination therapy in bipolar disorder may be related to severity of the BD, such as number of suicide attempts.
本研究旨在评估双相情感障碍患者自杀未遂与多种药物使用之间的关联。
纳入169例使用DSM-IV结构化临床访谈诊断的双相情感障碍门诊患者。使用结构化问卷和DSM-IV标准评估人口统计学和社会经济数据、当前正在使用的药物数量、自杀未遂史、未确诊年限、发病年龄和当前的精神共病情况。主要结局指标是当前正在使用的精神药物数量。
所有患者中约一半（48.5%）有自杀未遂史；84%的患者使用不止一种药物，19%的患者使用三种以上药物。这些患者最常使用的药物组合是：锂盐+丙戊酸盐（17%）；锂盐+抗精神病药物（10%）；锂盐+丙戊酸盐+抗精神病药物（9%）；以及抗抑郁药+任何药物（6%）。自杀未遂次数与多种药物的使用有关。
我们的研究结果支持这样一种观点，即双相情感障碍联合治疗的使用可能与双相情感障碍的严重程度有关，如自杀未遂次数。
