Perugi Giulio, Vannucchi Giulia, Barbuti Margherita, Maccariello Giuseppe, De Bartolomeis Andrea, Fagiolini Andrea, Maina Giuseppe
Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Pisa.
Laboratory of Molecular and Translational Psychiatry, Department of Neuroscience, Section of Psychiatry, University Medical School of Naples Federico II, Naples.
Int Clin Psychopharmacol. 2018 May;33(3):131-139. doi: 10.1097/YIC.0000000000000211.
This observational study aimed to identify internal (clinical-demographic, temperamental characteristics) and external (childhood trauma, psychosocial characteristics) factors potentially predicting remission at 12 weeks in bipolar-I patients experiencing manic episode and requiring to start or switch treatment with oral antipsychotics and/or mood stabilizers. The following scales were administered: the Young Mania Rating Scale (YMRS), the Montgomery-Asberg Depression Rating Scale (MADRS), the Functioning Assessment Short Test (FAST), and the Clinical Global Impression for Bipolar Disorders (CGI-BP). A logistic regression analysis was carried out to test the effect of the explored factors on remission rate (YMRS score ≤12), functionality, and clinical outcomes at week 12. Overall, 243 patients were enrolled and 197 (81.1%) completed the follow-up. Remission at week 12 was achieved in 200 (82.3%) patients. Marked improvements from baseline were observed in MADRS, FAST, CGI-BP mania, and bipolar illness scores. None of the factors was associated with remission, or showed strong correlations with the improvements in clinical health state. In our sample, after 12 weeks of initiation or change of oral therapy for mania in bipolar-I patients, treatment was associated with rapid improvements in symptoms and functioning in most patients. Factors predictive of remission and clinical improvements in manic symptoms were not identified.
这项观察性研究旨在确定可能预测双相 I 型障碍躁狂发作患者在 12 周时病情缓解的内部因素（临床人口统计学、气质特征）和外部因素（童年创伤、社会心理特征），这些患者需要开始或更换口服抗精神病药物和/或心境稳定剂治疗。使用了以下量表：杨氏躁狂评定量表（YMRS）、蒙哥马利-阿斯伯格抑郁评定量表（MADRS）、功能评估简短测试（FAST）以及双相障碍临床总体印象量表（CGI-BP）。进行了逻辑回归分析，以检验所探究因素对 12 周时缓解率（YMRS 评分≤12）、功能以及临床结局的影响。总体而言，共纳入 243 例患者，197 例（81.1%）完成了随访。200 例（82.3%）患者在 12 周时实现了病情缓解。观察到 MADRS、FAST、CGI-BP 躁狂和双相障碍评分较基线有显著改善。没有任何因素与缓解相关，也没有与临床健康状态改善表现出强相关性。在我们的样本中，双相 I 型障碍患者开始或改变口服躁狂治疗 12 周后，大多数患者的治疗与症状和功能的快速改善相关。未发现预测缓解和躁狂症状临床改善的因素。
