Differential prevalence and demographic and clinical correlates of second-generation antipsychotic use in bipolar I versus bipolar II disorder |
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| Affiliation: | 1. Department of Psychiatry, Seoul National Hospital, Seoul, South Korea;2. Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA;1. King׳s College London, Institute of Psychiatry, Department of Psychological Medicine, Affective Disorders Research Group, 103 Denmark Hill, London SE5 8AZ, UK;2. The National Affective Disorders Unit, South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Monks Orchard Road, Beckenham, Kent BR3 3BX, UK;3. The NIHR Biomedical Research Centre at the South London and Maudsley NHS Foundation Trust and the Institute of Psychiatry, King׳s College London, London, UK;4. Addis Ababa University, College of Health Sciences, Department of Psychiatry, Addis Ababa, Ethiopia;5. Stress and Affective Disorders (SAD) Programme, Faculty of Medicine of Ribeirao Preto, University of Sao Paulo, Ribeirao Preto, Brazil;1. Dublin and East Treatment and Early Care Team (DETECT) Service, Blackrock, Co Dublin, Ireland;2. School of Medicine and Medical Sciences, University College Dublin, Belfield, Dublin, Ireland;3. UCD CSTAR, School of Public Health, Physiotherapy and Population Science, University College Dublin, Belfield, Dublin, Ireland;4. School of Nursing, Midwifery and Social Work, University of Manchester, UK;1. McLean Hospital, United States;2. Harvard Medical School, United States;1. The Institute of Living, Hartford, CT, USA;2. New York Medical College, USA |
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| Abstract: | AimsTo assess second-generation antipsychotic (SGA) use, demographics, and clinical correlates in patients with bipolar I disorder (BDI) versus bipolar II disorder (BDII).MethodsStanford Bipolar Disorder (BD) Clinic outpatients enrolled during 2000–2011 were assessed with the Systematic Treatment Enhancement Program for BD (STEP-BD) Affective Disorders Evaluation. Current SGA use, demographics, and clinical correlates were assessed for BDI versus BDII.ResultsAmong 503 BD outpatients, in BDI versus BDII, SGA use was more than twice as common (44.0% versus 21.2%), and doses were approximately twice as high. BDI patients taking (N = 107) versus not taking (N = 136) SGAs less often had current full time employment and college degree; and more often had lifetime psychiatric hospitalization, current depression, and current complex pharmacotherapy, and had a higher mean current Clinical Global Impression for Bipolar Version Overall Severity score, and these persisted significantly after covarying for employment and education. Prior psychiatric hospitalization was the most robust correlate of SGA use in BDI patients. In contrast, these demographic and clinical correlates of SGA use were not statistically significant among patients with BDII, although BDII (but not BDI) patients taking (N = 55) versus not taking (N = 205) SGAs were more likely to have current mood stabilizer use (67.3% versus 51.7%).LimitationsAmerican tertiary bipolar disorder clinic referral sample, cross-sectional design.ConclusionsCurrent SGA use was robustly associated with prior psychiatric hospitalization in BDI and to a more limited extent with current mood stabilizer use in BDII. SGA use associations with other unfavorable illness characteristics in BDI were less robust. |
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| Keywords: | Bipolar I disorder Bipolar II disorder Antipsychotics Prevalence Demographics Clinical correlates |
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