Department of Medicine, Surgery and Health Sciences, University of Trieste, 34128 Trieste, Italy.
Department of Mental Health, Psychiatric Clinic, Azienda Sanitaria Universitaria Giuliano-Isontina-ASUGI, 34128 Trieste, Italy.
Medicina (Kaunas). 2021 Jun 10;57(6):598. doi: 10.3390/medicina57060598.
: Predominant polarity (PP) may be a useful course specifier in at least a significant proportion of patients with Bipolar Disorder (BD), being associated with several clinically relevant correlates. Emerging evidence suggests that the concept of PP might influence the selection of maintenance treatments, based on a drug polarity index (PI) which measures the greater antidepressive vs. antimanic preventive efficacy of mood stabilizers over long-term maintenance treatment. In this study, we aimed to validate the PI in a large sample of Italian BD patients with accurate longitudinal characterization of the clinical course, which ensured a robust definition of the PP. : Our sample is comprised of 653 patients with BD, divided into groups based on the predominant polarity (manic/hypomanic predominant polarity-MPP, depressive predominant polarity-DPP and no predominant polarity). Subsequently we calculated the mean total polarity index for each group, and we compared the groups. : When we examined the mean PI of treatments prescribed to individuals with DPP, MPP and no predominant polarity, calculated using two different methods, we failed to find significant differences, with the exception of the PI calculated with the Popovic method and using the less stringent criterion for predominant polarity (PP). : Future prospective studies are needed in order to determine whether the predominant polarity is indeed one clinical factor that might guide the clinician in choosing the right mood stabilizer for BD maintenance treatment.
: 主导极性（PP）可能是至少相当一部分双相情感障碍（BD）患者的有用课程指定，与几个临床相关的相关性有关。新出现的证据表明，基于衡量心境稳定剂在长期维持治疗中抗抑郁作用与抗躁狂作用的差异的药物极性指数（PI），PP 这一概念可能会影响维持治疗的选择。在这项研究中，我们旨在通过对临床病程进行准确的纵向描述，在大量意大利 BD 患者样本中验证 PI，从而确保对 PP 进行稳健定义。: 我们的样本由 653 名 BD 患者组成，根据主导极性（躁狂/轻躁狂主导极性-MPP、抑郁主导极性-DPP 和无主导极性）分为组。随后，我们计算了每个组的平均总极性指数，并对组进行了比较。: 当我们检查使用两种不同方法计算的 DPP、MPP 和无主导极性个体所开处方治疗的平均 PI 时，除了使用更宽松的主导极性（PP）标准计算的 Popovic 方法外，我们没有发现显著差异。: 未来需要前瞻性研究，以确定主导极性是否确实是指导临床医生为 BD 维持治疗选择正确心境稳定剂的一个临床因素。
