Citation

Popović D, Torrent C, Goikolea JM, Cruz N, Sanchez-Moreno J, González-Pinto A, Vieta E. Acta Psychiatr. Scand. 2014; 129(5): 366-374.

Copyright

(Copyright © 2014, John Wiley and Sons)

DOI

10.1111/acps.12179

PMID

unavailable

Abstract

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: Two hundred and fifty-seven of 604 (43%) of patients with BD-I or II fulfilled criteria for manic (MPP) or depressive PP (DPP). The PI, representing the ratio of number needed to treat (NNT) for depression prevention to NNT for mania prevention, was calculated for patients' current treatment. MPP and DPP groups were compared regarding sociodemographic, clinical and therapeutic characteristics.

RESULTS: One hundred and forty-three 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. © 2013 John Wiley & Sons A/S.

Language: en

Keywords

Humans; Female; Male; adult; human; age; Severity of Illness Index; Depression; female; male; Psychiatric Status Rating Scales; Hospitalization; Prevalence; Treatment; bipolar disorder; Bipolar disorder; depression; prevalence; sex difference; randomized controlled trial; suicide attempt; Age of Onset; complication; lithium; hospitalization; Antidepressive Agents; bipolar depression; clozapine; psychology; Patient Selection; article; comparative study; major clinical study; antidepressant agent; clinical feature; priority journal; quetiapine; melancholia; psychopharmacotherapy; Bipolar Disorder; benzodiazepine derivative; carbamazepine; olanzapine; risperidone; onset age; valproic acid; gabapentin; lamotrigine; topiramate; ziprasidone; drug monitoring; Drug Monitoring; oxcarbazepine; tranquilizer; clinical decision making; psychological rating scale; patient selection; aripiprazole; bipolar mania; Antimanic Agents; statistics and numerical data; named inventories, questionnaires and rating scales; comparative effectiveness; severity of illness index; naturalistic inquiry; Naturalistic study; Comparative Effectiveness Research; polarity index; Polarity index; Pragmatic Clinical Trials as Topic; predominant polarity; Predominant polarity