Samalin Ludovic, Guillaume Sebastien, Auclair Candy, Llorca Pierre-Michel
Centre Hospitalier Universitaire, Clermont-Ferrand, France.
J Nerv Ment Dis. 2011 Apr;199(4):239-43. doi: 10.1097/NMD.0b013e3182125d4c.
The treatment modalities of bipolar disorder and adherence to international guidelines recommendations in France were investigated. We conducted an observational survey among 210 French psychiatrists concerning their prescribing practice in bipolar disorder, and whether they use guidelines or not. Simple mania is mainly treated with valproate, whereas second-generation antipsychotics are preferred for delusional mania. Lithium is mostly used as second-line treatment by "young psychiatrists." Personal experience appears in the foreground (41% of psychiatrists) in the choice of therapy. Young psychiatrists refer more to guidelines (32% of responders) as compared with other psychiatrists. The main reason for the lack of use of guidelines is because they refer mostly to an Anglo-Saxon medical practice, which is considered different from the French practice. Guidelines for treatment of bipolar disorder are not frequently used. French psychiatrists' age and practice type are the most important variables correlated to the level of use of guidelines.
对法国双相情感障碍的治疗方式及遵循国际指南建议的情况进行了调查。我们对210名法国精神科医生就其双相情感障碍的处方实践以及是否使用指南进行了一项观察性调查。单纯躁狂主要用丙戊酸盐治疗，而第二代抗精神病药物则更常用于妄想性躁狂。锂盐大多被“年轻精神科医生”用作二线治疗。在治疗选择上，个人经验（41%的精神科医生）显得更为重要。与其他精神科医生相比，年轻精神科医生更多地参考指南（32%的应答者）。不使用指南的主要原因是它们大多参考的是盎格鲁-撒克逊医学实践，被认为与法国的实践不同。双相情感障碍的治疗指南不常被使用。法国精神科医生的年龄和执业类型是与指南使用水平相关的最重要变量。
