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BIPOLAR DISORDER: THE IMPORTANCE OF CLINICAL ASSESSMENT IN IDENTIFYING PROGNOSTIC FACTORS - AN AUDIT. Part 3: A comparison between Italian and English mental health services and a survey of bipolar disorder
Norma Verdolini
; School of Specialization in Psychiatry, Division of Psychiatry, Clinical Psychology and Rehabilitation, Department of Medicine, University of Perugia, Santa Maria della Misericordia Hospital, Perugia, Italy
Jonathon Dean
; School of Clinical Medicine, University of Cambridge, Addenbrooke’s Hospital Gonville and Caius College, Cambridge, UK
Giampaolo Massucci
; Community Mental Health Service in Bastia Umbra, Italy
Sandro Elisei
; Division of Psychiatry, Clinical Psychology and Rehabilitation, Department of Medicine, University of Perugia, Santa Maria della Misericordia Hospital, Perugia, Italy
Roberto Quartesan
; Division of Psychiatry, Clinical Psychology and Rehabilitation, Department of Medicine, University of Perugia, Santa Maria della Misericordia Hospital, Perugia, Italy
Rashid Zaman
; Division of Psychiatry, Clinical Psychology and Rehabilitation, Department of Medicine, University of Perugia, Santa Maria della Misericordia Hospital, Perugia, Italy ; South Essex Partnership University Foundation Trust, Bedfordshire Centre for Mental Health Research in association with the University of Cambridge, Department of Psychiatry, University of Cambridge, UK
Mark Agius
; South Essex Partnership University Foundation Trust, Bedfordshire Centre for Mental Health Research in association with the University of Cambridge, Department of Psychiatry, University of Cambridge, UK ; Clare College Cambridge, The University of Cambridge, Cambridge, UK
Sažetak
Background: Most of the prognostic factors of bipolar disorder, which determine disease course and outcome, could be detected
from simple but often-unrecorded questions asked during the psychiatric clinic assessments. In previous parts of this research, we
analysed various prognostic factors and focused on mixed states and rapid cycling subsets. We now compare our sample in England
with a small sample from Italy to demonstrate the utility of focused prognostic questioning and of international comparison.
Methods: We collected data from the clinical notes of 70 English bipolar and 8 Italian bipolar outpatients seen at the initial
psychiatric assessment clinic about socio-demographic and clinical factors to determine whether various factors had relevance to
prevalence, prognosis, or outcome.
Results:The sample comprised 16 bipolar I (22.9%) and 54 bipolar II (77.1%) English outpatients and 7 bipolar I (87.5%) and 1
bipolar II (12.5%) Italian outpatients. Differences between the groups are seen mainly in terms of age of onset, duration of both
depressive and hypomanic episodes, presence of psychiatric family history, incidence of mixed state features and rapid cycling,
presence of elated mood in response to past antidepressant treatment, and misuse of illicit drugs and alcohol.
Conclusions: In order to promote improved mental health primary care, mental health systems in all countries should develop
standardized epidemiological tools that are shared between countries. We recommend the use of a questionnaire that reminds
clinicians of potentially prognostic information and suggest that this might identify important components of a potential standardized
diagnostic and prognostic tool.
Ključne riječi
bipolar affective disorder; prognostic factors; comorbidity; mixed affective states; rapid cycling
Hrčak ID:
265735
URI
Datum izdavanja:
5.11.2014.
Posjeta: 211 *