Pharmacological treatment and staging in bipolar disorder : evidence from clinical practice
Autor(a) principal: | |
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Data de Publicação: | 2015 |
Outros Autores: | , , , , , , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Institucional da UFRGS |
Texto Completo: | http://hdl.handle.net/10183/129426 |
Resumo: | Objective: Staging models for medical diseases are widely used to guide treatment and prognosis. Bipolar disorder (BD) is a chronic condition and it is among the most disabling disorders in medicine. The staging model proposed by Kapczinski in 2009 presents four progressive clinical stages of BD. Our aim was to evaluate pharmacological maintenance treatment across these stages in patients with BD. Methods: One hundred and twenty-nine subjects who met DSM-IV criteria for BD were recruited from the Bipolar Disorders Program at Hospital de Clínicas de Porto Alegre, Brazil. All patients were in remission. The subjects were classified according to the staging model: 31 subjects were classified as stage I, 44 as stage II, 31 as stage III, and 23 as stage IV. Results: Patterns of pharmacological treatment differed among the four stages (p = 0.001). Monotherapy was more frequent in stage I, and two-drug combinations in stage II. Patients at stages III and IV needed three or more medications or clozapine. Impairment in functional status (Functioning Assessment Short Test [FAST] scale scores) correlated positively with the number of medications prescribed. Conclusions: This study demonstrated differences in pharmacological treatment in patients with stable BD depending on disease stage. Treatment response can change with progression of BD. Clinical guidelines could consider the staging model to guide treatment effectiveness. |
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Goi, Pedro DominguesBücker, JoanaSulzbach, Miréia Fortes ViannaRosa, Adriane RibeiroGrande, IriaChendo, InêsSodré, Leonardo de AlmeidaKauer-Sant'Anna, MárciaSilveira, Leonardo Evangelista daKunz, MaurícioCeresér, Keila Maria MendesGama, Clarissa SeverinoMassuda, Raffael2015-11-10T02:41:13Z20151516-4446http://hdl.handle.net/10183/129426000974271Objective: Staging models for medical diseases are widely used to guide treatment and prognosis. Bipolar disorder (BD) is a chronic condition and it is among the most disabling disorders in medicine. The staging model proposed by Kapczinski in 2009 presents four progressive clinical stages of BD. Our aim was to evaluate pharmacological maintenance treatment across these stages in patients with BD. Methods: One hundred and twenty-nine subjects who met DSM-IV criteria for BD were recruited from the Bipolar Disorders Program at Hospital de Clínicas de Porto Alegre, Brazil. All patients were in remission. The subjects were classified according to the staging model: 31 subjects were classified as stage I, 44 as stage II, 31 as stage III, and 23 as stage IV. Results: Patterns of pharmacological treatment differed among the four stages (p = 0.001). Monotherapy was more frequent in stage I, and two-drug combinations in stage II. Patients at stages III and IV needed three or more medications or clozapine. Impairment in functional status (Functioning Assessment Short Test [FAST] scale scores) correlated positively with the number of medications prescribed. Conclusions: This study demonstrated differences in pharmacological treatment in patients with stable BD depending on disease stage. Treatment response can change with progression of BD. Clinical guidelines could consider the staging model to guide treatment effectiveness.application/pdfengRevista brasileira de psiquiatria = Brazilian journal of psychiatry. São Paulo. Vol. 37, n. 2 (abr./jun. 2015), p. 121-125Transtorno bipolarDiagnósticoAnticonvulsivantesAntidepressivosAntipsicóticosBipolar mood disordersAnticonvulsantsAntidepressantsAntipsychoticsDiagnosis and classificationPharmacological treatment and staging in bipolar disorder : evidence from clinical practiceinfo:eu-repo/semantics/articleinfo:eu-repo/semantics/otherinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da UFRGSinstname:Universidade Federal do Rio Grande do Sul (UFRGS)instacron:UFRGSORIGINAL000974271.pdf000974271.pdfTexto completo (inglês)application/pdf697210http://www.lume.ufrgs.br/bitstream/10183/129426/1/000974271.pdfe47dacda418c5a7fd1766fcda535276fMD51TEXT000974271.pdf.txt000974271.pdf.txtExtracted Texttext/plain27780http://www.lume.ufrgs.br/bitstream/10183/129426/2/000974271.pdf.txt97a69b3502b22f908382f7f52b35d2d1MD52THUMBNAIL000974271.pdf.jpg000974271.pdf.jpgGenerated Thumbnailimage/jpeg2002http://www.lume.ufrgs.br/bitstream/10183/129426/3/000974271.pdf.jpg4e316d56beffa2c16859b4c2485a30c1MD5310183/1294262023-09-01 03:31:09.015519oai:www.lume.ufrgs.br:10183/129426Repositório de PublicaçõesPUBhttps://lume.ufrgs.br/oai/requestopendoar:2023-09-01T06:31:09Repositório Institucional da UFRGS - Universidade Federal do Rio Grande do Sul (UFRGS)false |
dc.title.pt_BR.fl_str_mv |
Pharmacological treatment and staging in bipolar disorder : evidence from clinical practice |
title |
Pharmacological treatment and staging in bipolar disorder : evidence from clinical practice |
spellingShingle |
Pharmacological treatment and staging in bipolar disorder : evidence from clinical practice Goi, Pedro Domingues Transtorno bipolar Diagnóstico Anticonvulsivantes Antidepressivos Antipsicóticos Bipolar mood disorders Anticonvulsants Antidepressants Antipsychotics Diagnosis and classification |
title_short |
Pharmacological treatment and staging in bipolar disorder : evidence from clinical practice |
title_full |
Pharmacological treatment and staging in bipolar disorder : evidence from clinical practice |
title_fullStr |
Pharmacological treatment and staging in bipolar disorder : evidence from clinical practice |
title_full_unstemmed |
Pharmacological treatment and staging in bipolar disorder : evidence from clinical practice |
title_sort |
Pharmacological treatment and staging in bipolar disorder : evidence from clinical practice |
author |
Goi, Pedro Domingues |
author_facet |
Goi, Pedro Domingues Bücker, Joana Sulzbach, Miréia Fortes Vianna Rosa, Adriane Ribeiro Grande, Iria Chendo, Inês Sodré, Leonardo de Almeida Kauer-Sant'Anna, Márcia Silveira, Leonardo Evangelista da Kunz, Maurício Ceresér, Keila Maria Mendes Gama, Clarissa Severino Massuda, Raffael |
author_role |
author |
author2 |
Bücker, Joana Sulzbach, Miréia Fortes Vianna Rosa, Adriane Ribeiro Grande, Iria Chendo, Inês Sodré, Leonardo de Almeida Kauer-Sant'Anna, Márcia Silveira, Leonardo Evangelista da Kunz, Maurício Ceresér, Keila Maria Mendes Gama, Clarissa Severino Massuda, Raffael |
author2_role |
author author author author author author author author author author author author |
dc.contributor.author.fl_str_mv |
Goi, Pedro Domingues Bücker, Joana Sulzbach, Miréia Fortes Vianna Rosa, Adriane Ribeiro Grande, Iria Chendo, Inês Sodré, Leonardo de Almeida Kauer-Sant'Anna, Márcia Silveira, Leonardo Evangelista da Kunz, Maurício Ceresér, Keila Maria Mendes Gama, Clarissa Severino Massuda, Raffael |
dc.subject.por.fl_str_mv |
Transtorno bipolar Diagnóstico Anticonvulsivantes Antidepressivos Antipsicóticos |
topic |
Transtorno bipolar Diagnóstico Anticonvulsivantes Antidepressivos Antipsicóticos Bipolar mood disorders Anticonvulsants Antidepressants Antipsychotics Diagnosis and classification |
dc.subject.eng.fl_str_mv |
Bipolar mood disorders Anticonvulsants Antidepressants Antipsychotics Diagnosis and classification |
description |
Objective: Staging models for medical diseases are widely used to guide treatment and prognosis. Bipolar disorder (BD) is a chronic condition and it is among the most disabling disorders in medicine. The staging model proposed by Kapczinski in 2009 presents four progressive clinical stages of BD. Our aim was to evaluate pharmacological maintenance treatment across these stages in patients with BD. Methods: One hundred and twenty-nine subjects who met DSM-IV criteria for BD were recruited from the Bipolar Disorders Program at Hospital de Clínicas de Porto Alegre, Brazil. All patients were in remission. The subjects were classified according to the staging model: 31 subjects were classified as stage I, 44 as stage II, 31 as stage III, and 23 as stage IV. Results: Patterns of pharmacological treatment differed among the four stages (p = 0.001). Monotherapy was more frequent in stage I, and two-drug combinations in stage II. Patients at stages III and IV needed three or more medications or clozapine. Impairment in functional status (Functioning Assessment Short Test [FAST] scale scores) correlated positively with the number of medications prescribed. Conclusions: This study demonstrated differences in pharmacological treatment in patients with stable BD depending on disease stage. Treatment response can change with progression of BD. Clinical guidelines could consider the staging model to guide treatment effectiveness. |
publishDate |
2015 |
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2015-11-10T02:41:13Z |
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2015 |
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http://hdl.handle.net/10183/129426 |
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1516-4446 |
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000974271 |
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dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.ispartof.pt_BR.fl_str_mv |
Revista brasileira de psiquiatria = Brazilian journal of psychiatry. São Paulo. Vol. 37, n. 2 (abr./jun. 2015), p. 121-125 |
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