Predominant polarity in bipolar disorder and validation of the polarity index in a German sample

BMC Psychiatry

Andreas Reif¹  Sarah Kittel-Schneider¹  Juliane Kopf¹  Martina Wenzel²  Miriam A Schiele²  Kathrin C Zierhut²  Julia Volkert¹ 

[1] Department of Psychiatry, Psychosomatic Medicine and Psychotherapy Goethe-University, Heinrich-Hoffmann-Straße 10, Frankfurt am Main D-60528, Germany;Department of Psychiatry, Psychosomatics and Psychotherapy, University of Wuerzburg, Fuechsleinstrasse 15, Wuerzburg D-97080, Germany

关键词: EBM;    Mania;    Depression;    Maintenance treatment;    Polarity index;    Predominant polarity;    Bipolar disorder;   

Others  :  1092148
DOI  :  10.1186/s12888-014-0322-8

 received in 2014-09-03, accepted in 2014-11-04,  发布年份 2014

【 摘 要 】

Background

A large number of patients with bipolar disorder (BD) can be characterized by predominant polarity (PP), which has important implications for relapse prevention. Recently, Popovic et al. (EUR NEUROPSYCHOPHARM 22(5): 339–346, 2012) proposed the Polarity Index (PI) as a helpful tool in the maintenance treatment of BD. As a numeric expression, it reflects the efficacy of drugs used in treatment of BD. In the present retrospective study, we aimed to validate this Index in a large and well characterized German bipolar sample.

Methods

We investigated 336 bipolar patients (BP) according to their PP and calculated the PI for each patient in order to prove if maintenance treatment differs according to their PP. Furthermore, we analysed whether PP is associated with demographic and clinical characteristics of BP.

Results

In our sample, 63.9% of patients fulfilled criteria of PP: 169 patients were classified as depressive predominant polarity (DPP), 46 patients as manic predominant polarity (MPP). The two groups differed significantly in their drug regime: Patients with DPP were more often medicated with lamotrigine and antidepressants, patients with MPP were more often treated with lithium, valproate, carbamazepine and first generation antipsychotics. However, patients with DPP and MPP did not differ significantly with respect to the PI, although they received evidence-based and guideline-driven treatment.

Conclusion

The reason for this negative finding might well be that for several drugs, which were used frequently, no PI value is available. Nevertheless we suggest PP as an important concept in the planning of BD maintenance treatment.

【 授权许可】

   
2014 Volkert et al.; licensee BioMed Central Ltd.

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