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ADHERENCE TO TURKISH PSYCHIATRIC ASSOCIATION GUIDELINE FOR BIPOLAR DEPRESSION TREATMENT IN A SPECIALIZED MOOD DISORDERS OUTPATIENT UNIT

Kürşat Altınbaş orcid id orcid.org/0000-0003-2899-0096 ; Bakırköy Research and Training Hospital for Psychiatry, Neurology & Neurosurgery Raşit Tahsin Mood Disorders Outpatient Unit, Istanbul, Turkey
Danny Smith ; Department of Psychological Medicine and Neurology, Cardiff University School of Medicine, Cardiff, UK
E. Timuçin Oral ; Bakırköy Research and Training Hospital for Psychiatry, Neurology & Neurosurgery Raşit Tahsin Mood Disorders Outpatient Unit, Istanbul, Turkey


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Sažetak

Background: Bipolar patients spend up to one third of their lives in depression however, acute treatment guidelines mainly
focused on the manic phase of illness. With recent attention to the importance of evidence-based medicine in psychiatry, a number of
treatment guidelines have emerged to aid clinicians in clinical decision making. Here, we aim to measure concordance with the
Turkish Psychiatric Association Treatment Guideline for Bipolar Disorders (TPATGBD) for the depressive phase of illness.
Subjects and Methods: Bipolar patients attending the Rasit Tahsin Mood Disorders Outpatient Unit of Istanbul Bakırköy
Research and Training Hospital for Psychiatry, Neurolgy & Neurosurgery, were assessed using standardized forms based on a
nation-wide mood disorders follow-up program. Concordance of implementations with the TPATGBD were evaluated step by step
for each level of depression severity.
Results: Concordance rates with the first step recommendations of the guideline were 29.4%, 27.4% and 87.5% for mildmoderate,
moderate-severe (without psychosis) and severe depression (with psychosis), respectively. Concordance rates with the
second step recommendations of the guideline were lower for bipolar depressions without psychosis. Overall, adherence to the
guideline did not impact on time to remission (p=0.19).
Conclusions: Despite considerable efforts to develop and disseminate evidence-based guidelines, they are not widely followed by
clinicians and important opportunities clearly exist to educate clinicians about the feasibility and utility of clinical guidelines for
bipolar disorder. Systematic studies in the future are required to clarify our understanding of clinicians’ attitudes to the use of
guidelines and to explain the discrepancy between guidelines and clinical practice.

Ključne riječi

treatment guidelines; bipolar depression; adherence

Hrčak ID:

76817

URI

https://hrcak.srce.hr/76817

Datum izdavanja:

30.6.2011.

Posjeta: 887 *