Treatment and outcomes of an Australian cohort of outpatients with bipolar I or schizoaffective disorder over twenty-four months: implications for clinical practice

BMC Psychiatry

Research Article

Michael Berk¹  Lesley Berk²  Seetal Dodd³  Amanda J Lowry⁴  Katarina Kelin⁴  William Montgomery⁵  Sacha Filia⁶  Anthony de Castella⁶  Kate Filia⁶  Jayashri Kulkarni⁶  Paul B Fitzgerald⁶  Alan JM Brnabic⁷ 

[1] Department of Psychiatry, The University of Melbourne, 3010, Parkville, VIC, Australia;Orygen Research Centre, 3052, Parkville, VIC, Australia;Florey Institute for Neuroscience and Mental Health, University of Melbourne, 3010, Parkville, Victoria, Australia;School of Medicine, Deakin University, 3220, Geelong, VIC, Australia;Department of Psychiatry, The University of Melbourne, 3010, Parkville, VIC, Australia;Orygen Research Centre, 3052, Parkville, VIC, Australia;School of Medicine, Deakin University, 3220, Geelong, VIC, Australia;Department of Psychiatry, The University of Melbourne, 3010, Parkville, VIC, Australia;School of Medicine, Deakin University, 3220, Geelong, VIC, Australia;Eli Lilly Australia Pty Ltd, 112 Wharf Road, 2114, West Ryde, NSW, Australia;Global Health Outcomes, Intercontinental Region, Eli Lilly Australia Pty Ltd, 112 Wharf Road, 2114, West Ryde, NSW, Australia;Monash Alfred Psychiatry Research Centre, The Alfred Hospital and Monash University, Central Clinical School, 607 St Kilda Rd, 3004, Melbourne, VIC, Australia;Optum, 2040, Lilyfield, NSW, Australia;

关键词: Bipolar Disorder;    Olanzapine;    Propensity Score;    Study Entry;    Mood Stabilizer;   

DOI  :  10.1186/1471-244X-12-228

 received in 2011-12-01, accepted in 2012-12-15,  发布年份 2012

来源: Springer

【 摘 要 】

BackgroundThe Bipolar Comprehensive Outcomes Study (BCOS) is a 2-year, prospective, non-interventional, observational study designed to explore the clinical and functional outcomes associated with ‘real-world’ treatment of participants with bipolar I or schizoaffective disorder. All participants received treatment as usual. There was no study medication.MethodsParticipants prescribed either conventional mood stabilizers (CMS; n = 155) alone, or olanzapine with, or without, CMS (olanzapine ± CMS; n = 84) were assessed every 3 months using several measures, including the Young Mania Rating Scale, 21-item Hamilton Depression Rating Scale, Clinical Global Impressions Scale – Bipolar Version, and the EuroQol Instrument. This paper reports 24-month longitudinal clinical, pharmacological, functional, and socioeconomic data.ResultsOn average, participants were 42 (range 18 to 79) years of age, 58%; were female, and 73%; had a diagnosis of bipolar I. Polypharmacy was the usual approach to pharmacological treatment; participants took a median of 5 different psychotropic medications over the course of the study, and spent a median proportion of time of 100%; of the study on mood stabilizers, 90%; on antipsychotics, 9%; on antidepressants, and 5%; on benzodiazepines/hypnotics. By 24 months, the majority of participants had achieved both symptomatic and syndromal remission of both mania and depression. Symptomatic relapse rates were similar for both the CMS alone (65%;) and the olanzapine ± CMS (61%;) cohorts.ConclusionsParticipants with bipolar I or schizoaffective disorder in this study were receiving complex medication treatments that were often discordant with recommendations made in contemporary major treatment guidelines. The majority of study participants demonstrated some clinical and functional improvements, but not all achieved remission of symptoms or syndrome.

【 授权许可】

CC BY   
© Kulkarni et al.; licensee BioMed Central Ltd. 2012