Naturalistic study of the efficacy of different treatment strategies in relapse prevention in bipolar affective disorders
Marzanski, Marek, Jainer, Ashok Kumar and Stallard, Nigel. (2008) Naturalistic study of the efficacy of different treatment strategies in relapse prevention in bipolar affective disorders. International Medical Journal, Vol.15 (No.4). pp. 277-285. ISSN 1341-2051Full text not available from this repository.
Bipolar affective disorder is a severe mental illness and is reported as the 6th leading cause of disability worldwide. Mood stabilisers such as lithium and anticonvulsants have been used in the therapy of bipolar affective disorder. The evaluation of the outcome of the treatment is usually based on the data from randomised controlled trials. There has been need for naturalistic studies of the pharmacological interventions in bipolar affective disorder.
Aims: 1. To compare their effectiveness in relapse prevention
2. To investigate some other predictors of relapse
Method: Seventy one patients aged 18-70 years with the clinical diagnosis of bipolar affective disorder were included in the study. The longitudinal data on bipolar disorder admissions were analysed using statistical modelling approaches. The time to relapse and duration of hospital admission were analysed using Cox proportional hazards regression models.
Results: The Number of previous admission had a significant effect on the time to the subsequent relapse (p = 0.05) with patients with more than seven previous admission having a significant shorter time to relapse than those with at most two previous admissions (hazard ratio = 1.16). The patients in full time employment had longer times to the first relapse (p = 0.01) and subsequent relapses (p = 001) than unemployed or part time employed. Time to relapse correlated also with he support received from community psychiatric nurse, the patients supported by community psychiatric nurse had shorter time to relapse (p = 0.022). Patients detained in the hospital under mental health act stayed longer than those admitted informally (p = 0.018).
Conclusions: The time to relapse has been influenced by the number of previous hospitalisations, patients' employment status and support from community psychiatric nurse. The duration of the hospitalisations correlated with the employment status and the use of the Mental Health Act (1983). Patients employed had shorter hospitalisations than unemployed and those admitted compulsory stayed in the hospital longer than those admitted informally.
|Item Type:||Journal Article|
|Subjects:||R Medicine > R Medicine (General)
R Medicine > RC Internal medicine > RC0321 Neuroscience. Biological psychiatry. Neuropsychiatry
R Medicine > RM Therapeutics. Pharmacology
|Divisions:||Faculty of Medicine > Warwick Medical School > Health Sciences
Faculty of Medicine > Warwick Medical School
|Library of Congress Subject Headings (LCSH):||Affective disorders -- Treatment -- Evaluation, Manic-depressive illness -- Treatment -- Evaluation, Manic-depressive illness -- Relapse, Clinical trials|
|Journal or Publication Title:||International Medical Journal|
|Publisher:||Japan International Cultural Exchange Foundation|
|Official Date:||September 2008|
|Number of Pages:||9|
|Page Range:||pp. 277-285|
|Access rights to Published version:||Restricted or Subscription Access|
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