TITLE

The management of bipolar mania: a national survey of baseline data from the EMBLEM study in Italy

AUTHOR(S)
Bellantuono, Cesario; Barraco, Alessandra; Rossi, Andrea; Goetz, Iris
PUB. DATE
January 2007
SOURCE
BMC Psychiatry;2007, Vol. 7, p33
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Background: Although a number of studies have assessed the management of mania in routine clinical practice, no studies have so far evaluated the short- and long-term management and outcome of patients affected by bipolar mania in different European countries. The objective of the study is to present, in the context of a large multicenter survey (EMBLEM study), an overview of the baseline data on the acute management of a representative sample of manic bipolar patients treated in the Italian psychiatric hospital and community settings. EMBLEM is a 2-year observational longitudinal study that evaluates across 14 European countries the patterns of the drug prescribed in patients with bipolar mania, their socio-demographic and clinical features and the outcomes of the treatment. Methods: The study consists of a 12-week acute phase and a ≥ 24-month maintenance phase. Bipolar patients were included into the study as in- or out-patients, if they initiated or changed, according to the decision of their psychiatrist, oral antipsychotics, anticonvulsants and/or lithium for the treatment of an episode of mania. Data concerning socio-demographic characteristics, psychiatric and medical history, severity of mania, prescribed medications, functional status and quality of life were collected at baseline and during the follow-up period. Results: In Italy, 563 patients were recruited in 56 sites: 376 were outpatients and 187 inpatients. The mean age was 45.8 years. The mean CGI-BP was 4.4 (± 0.9) for overall score and mania, 1.9 (± 1.2) for depression and 2.6 (± 1.6) for hallucinations/delusions. The YMRS showed that 14.4% had a total score < 12, 25.1% ≥ 12 and < 20, and 60.5% ≥ 20. At entry, 75 patients (13.7%) were treatment-naïve, 186 (34.1%) were receiving a monotherapy (of which haloperidol [24.2%], valproate [16.7%] and lithium [14.5%] were the most frequently prescribed) while 285 (52.2%) a combined therapy (of which 8.0% were represented by haloperidol/lithium combinations). After a switch to an oral medication, 137 patients (24.8%) were prescribed a monotherapy while the rest (415, 75.2%) received a combination of drugs. Conclusion: Data collected at baseline in the Italian cohort of the EMBLEM study represent a relevant source of information to start addressing the short and long-term therapeutic strategies for improving the clinical as well as the socio-economic outcomes of patients affected by bipolar mania. Although it's not an epidemiological investigation and has some limitations, the results show several interesting findings as a relatively late age of onset of bipolar disorder, a low rate of past suicide attempts, a low lifetime rate of alcohol abuse and drug addiction.
ACCESSION #
29962949

 

Related Articles

  • Managing Bipolar Disorder in the Primary Care Setting: A Perspective for Mental Health Professionals. Sansone, Randy A.; Sansone, Lori A. // Innovations in Clinical Neuroscience;Oct2011, Vol. 8 Issue 10, p10 

    Bipolar disorder affects between 1.3 percent and 1.6 percent of the general population. According to available evidence, prevalence rates appear to be even higher in primary care settings. The diagnosis and management of patients with bipolar disorder are potentially complicated by a number of...

  • The Role of Psychotherapy in the Bipolar Disorders. Young, Barbara // Annals of the American Psychotherapy Association;Spring2010, Vol. 13 Issue 1, p42 

    The author looks at the role of psychotherapy in the treatment of bipolar disorders. She offers a description of the unique approaches six patients required to treat bipolar I, bipolar II and temporary bipolar disorders. Among the objectives in treating those suffering from such conditions have...

  • Treatment Research in Bipolar Disorder: Issues and Recommendations. Baldessarini, R.J. // CNS Drugs;2002, Vol. 16 Issue 11, p721 

    Bipolar (manic-depressive) disorder is one of the most common of the severe mental illnesses. Officially recognised forms comprise type I (with mania), type II (with hypomania), cyclothymia and a rapid-cycling subtype. International lifetime prevalence estimates are 1 to 5% of the general...

  • Emerging Options in the Treatment of Bipolar Disorders. Berk, M.; Segal, J.; Janet, L.; Vorster, M. // Drugs;Jul2001, Vol. 61 Issue 10, p1407 

    Bipolar disorder is a common and severe condition, and has a clinical outcome that is frequently sub-optimal. Only a small number of therapeutic options are currently available for the disorder. A growing range of novel therapeutic options for the treatment of bipolar disorder are under...

  • Antiepileptics protect against suicidality in bipolar patients.  // Reactions Weekly;1/30/2010, Issue 1286, p2 

    The article discusses research on the association between antiepileptic drugs and suicide attempts in patients with bipolar disorder, that references a study by R. D. Gibbons, published in a 2009 issue of "Archives of General Psychiatry."

  • Terapia farmacologica e suicidio: l'esperienza del Gabapentin e della Quetiapina. Considerazioni medico-legali basate su una meta-analisi. Simeone, Claudio; Mastronardi, Vincenzo; Massoni, Francesco; Ricci, Serafino // Rivista di Criminologia, Vittimologia e Sicurezza; 

    Gabapentin and Quietiapina are two drugs belonging to two different pharmaceutical classes thus offering different therapeutic indications. They both share the negative feature of being related to a possible implication in suicidal events. Moreover, the latest off-label use of Gabapentin for the...

  • Bipolar disorder: A brief examination of lithium therapy. Farinde, Abimbola // Journal of Basic & Clinical Pharmacy;Sep-Nov2013, Vol. 4 Issue 4, p93 

    The article examines the effectiveness of lithium therapy in treating bipolar disorder. It discusses the diagnostic methods and core symptoms of bipolar disorder. It indicates that the use of lithium is beneficial during acute and maintenance phase of bipolar disorders and in preventing relapse...

  • NEUROPSYCHIATRY. Blomgren, Donna // Journal of Pharmacy Practice & Research;Sep2012, Vol. 42 Issue 3, p241 

    The article offers abstracts on neuropsychiatry topics which include a case study of delirium in a Sheehan’s Syndrome patient, risk factors for suicide, and the addition of sertindole to a clozapine regimen for the prevention of cognitive impairment in schizophrenia.

  • Amoxapine.  // Reactions Weekly;1/26/2008, Issue 1186, p8 

    The article describes the case of a 37-year-old woman who developed acute respiratory distress during treatment with amoxapine for bipolar depression. She started receiving amoxapine, lorazepam and paroxetine to control depression. She attempted suicide by ingesting a large volume of alcohol and...

Share

Read the Article

Courtesy of VIRGINIA BEACH PUBLIC LIBRARY AND SYSTEM

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics