Department of Biomedical and Clinical Sciences 'Luigi Sacco'.
Department of Mental Health, ASST Fatebenefratelli-Sacco, Università degli Studi di Milano.
Int Clin Psychopharmacol. 2020 Jan;35(1):8-18. doi: 10.1097/YIC.0000000000000282.
Assess bipolar disorder subtype and treatment location effects on bipolar disorder core pharmacotherapy. Outpatients not in a syndromal episode referred to the University of Milan and Stanford University Bipolar Disorder Clinics were assessed with SCID for the fourth Edition of the Diagnostic and Statistical Manual of Mood Disorders, and the Systematic Treatment Enhancement Program for Bipolar Disorder Affective Disorders Evaluation, respectively. Prevalence and clinical correlates of antidepressant, antipsychotic, and mood stabilizer use, in aggregate and individually, were compared in bipolar I (BDI) versus II (BDII) patients in Milan/Stanford and in Milan versus Stanford patients, stratified by subtype. Milan/Stanford pooled BDI versus BDII patients significantly more often took antipsychotic (69.8 versus 44.8%), mood stabilizers (68.6 versus 57.7%), and valproate (40.1 versus 17.5%), and less often took antidepressants (23.1 versus 55.6%) and lamotrigine (9.9 versus 25.2%). Milan versus Stanford patients (stratified by bipolar disorder subtype) significantly more often took antipsychotic (BDI and BDII), antidepressants (BDII), and valproate (BDII), and less often took lamotrigine (BDI). Research regarding bipolar disorder core pharmacotherapy relationships with bipolar subtype and treatment location is warranted to enhance clinical management.
评估双相情感障碍亚型和治疗地点对双相情感障碍核心药物治疗的影响。未处于综合征发作期的门诊患者被转介到米兰大学和斯坦福大学双相情感障碍诊所,分别使用《精神障碍诊断与统计手册》第四版和系统性治疗增强计划对双相情感障碍情感障碍评估进行 SCID 评估。在米兰/斯坦福和米兰与斯坦福的患者中,按亚型分层,比较了双相 I 型(BDI)与 II 型(BDII)患者中抗抑郁药、抗精神病药和心境稳定剂的使用情况,包括总体情况和个体情况。米兰/斯坦福汇总的 BDI 与 BDII 患者更常使用抗精神病药(69.8%与 44.8%)、心境稳定剂(68.6%与 57.7%)和丙戊酸盐(40.1%与 17.5%),而较少使用抗抑郁药(23.1%与 55.6%)和拉莫三嗪(9.9%与 25.2%)。按双相情感障碍亚型分层的米兰与斯坦福患者更常使用抗精神病药(BDI 和 BDII)、抗抑郁药(BDII)和丙戊酸盐(BDII),而较少使用拉莫三嗪(BDI)。需要进行关于双相情感障碍核心药物治疗与双相情感障碍亚型和治疗地点关系的研究,以增强临床管理。