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Tesi etd-01152013-173253


Thesis type
Tesi di dottorato di ricerca
Author
POPOVIC, DINA
URN
etd-01152013-173253
Title
PREDOMINANT POLARITY AND THE POLARITY INDEX OF DRUGS USED IN MAINTENANCE TREATMENT OF BIPOLAR DISORDER
Settore scientifico disciplinare
MED/25
Corso di studi
NEUROSCIENZE E SCIENZE ENDOCRINOMETABOLICHE
Supervisors
tutor Dott. Perugi, Giulio
correlatore Prof. Vieta, Eduard
Parole chiave
  • polarity index
  • mood stabilizers
  • maintenance treatment
  • bipolar disorder
  • antipsychotics
Data inizio appello
23/01/2013;
Consultabilità
Completa
Riassunto analitico
Objective: Predominant polarity (PP) is an important variable in maintenance treatment of Bipolar Disorder (BD). This study aimed at determining the role of Polarity Index (PI), a metric indicating antimanic versus antidepressive prophylactic potential of drugs, in clinical decision-making.
Method: 257/604 (43%) of patients with BD-I or II fulfilled criteria for manic (MPP) or depressive PP (DPP).
The PI, representing Number Needed to Treat (NNT) for prevention of depression and NNT for mania prevention ratio, was calculated for patients’ current treatment.
MPP and DPP groups were compared regarding sociodemographic, clinical and therapeutic characteristics.
Results: 143 patients (55.6%) fulfilled criteria for DPP and 114 (44.4%) for MPP.
Total PI, Antipsychotics’ PI and Mood Stabilizers PI were higher, indicating a stronger antimanic action, in MPP. MPP presented higher prevalence of BD-I, male gender, younger age, age at onset and at first hospitalization, more hospitalizations, primary substance misuse and psychotic symptoms. DP correlated with BD-II, depressive onset, primary life events, melancholia and suicide attempts.
Conclusion: The results confirm the usefulness of the PI. In this large sample, clinical differences among these groups justify differential treatment approach. The PI appears to be a useful operationalization of what clinicians do for maintenance therapy in BD.
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