Mauer Sivan, Alahmari Rami, Vöhringer Paul A, Vergne Derick E, Lövdahl H, Correa E, Patkar A, Pae C, Strejilevich S, Dalley S, Ghaemi S Nassir
Mood Disorders Program, Tufts Medical Center; Tufts University Medical School, Boston, MA, USA.
Mood Disorders Program, Tufts Medical Center; Tufts University Medical School, Boston, MA, USA; Departamento de Psiquiatria, Hospital Clinico Universidad de Chile, Santiago de Chile.
J Affect Disord. 2014;167:136-9. doi: 10.1016/j.jad.2014.05.049. Epub 2014 Jun 2.
To show the feasibility of creating an international network that will build a common database for mood disorders research, and to present initial data on prescribing patterns worldwide.
An international research database was organized with clinicians and researchers actively treating mood disorders. Participating sites were asked to provide data on 10-50 subjects initially. This work was conducted under the auspices of a committee with representatives from North and South America, Europe, and Asia. Data was pooled from multiple sites using a centralized online system and then analyzed. Each site received IRB approval for its participation in the IMN and the Tufts Medical Center IRB provided approval for the entire project.
More than half of the population came from one country (United States) and there is the possibility of cultural bias.
Among the 186 subjects enrolled in the IMN, a majority of subjects were prescribed mood stabilizers including lithium (64%), lamotrigine (37%), valproate (31%), and carbamazepine (3%). 79% had a diagnosis of bipolar disorder type I, II or NOS and 21% had a diagnosis of MDD. 81% of subjects used antidepressants at some point. 25% experienced antidepressant-induced mania and 26% had antidepressant-related rapid cycling. Mood stabilizers were prescribed more in Europe (86%), neuroleptics in South America (70%), and antidepressants in Asia (58%).
The results confirm the diversity and feasibility of an international mood disorders database. Important regional differences in psychotropic drug treatment of mood illnesses were observed, with more mood stabilizer use in Europe and South America, and more antidepressant use in non-European populations.
展示创建一个国际网络的可行性，该网络将为情绪障碍研究建立一个通用数据库，并呈现全球处方模式的初始数据。
组织了一个国际研究数据库，参与者为积极治疗情绪障碍的临床医生和研究人员。要求参与站点最初提供10 - 50名受试者的数据。这项工作在一个由来自北美、南美、欧洲和亚洲代表组成的委员会主持下进行。使用集中式在线系统汇总多个站点的数据，然后进行分析。每个站点参与IMN均获得了机构审查委员会（IRB）的批准，塔夫茨医学中心IRB为整个项目提供了批准。
超过一半的人群来自一个国家（美国），存在文化偏见的可能性。
在IMN登记的186名受试者中，大多数受试者被开具了情绪稳定剂，包括锂盐（64%）、拉莫三嗪（37%）、丙戊酸盐（31%）和卡马西平（3%）。79%的受试者被诊断为I型、II型或未特定型双相情感障碍，21%的受试者被诊断为重度抑郁障碍。81%的受试者在某个阶段使用过抗抑郁药。25%的受试者经历过抗抑郁药诱发的躁狂，26%的受试者有与抗抑郁药相关的快速循环。欧洲开具情绪稳定剂的比例更高（86%），南美洲开具抗精神病药的比例更高（70%），亚洲开具抗抑郁药的比例更高（58%）。
结果证实了国际情绪障碍数据库的多样性和可行性。观察到情绪疾病精神药物治疗存在重要的地区差异，欧洲和南美洲更多使用情绪稳定剂，非欧洲人群更多使用抗抑郁药。
