title: Management of bipolar disorder in the intercontinental region: an international, multicenter, non-interventional, cross-sectional study in real-life conditions.
abstract: Most of the existing data on real-life management of bipolar disorder are from studies conducted in western countries (mostly United States and Europe). This multinational, observational cohort study aimed to describe the management and clinical outcomes of bipolar patients in real-life conditions across various intercontinental countries (Bangladesh, Egypt, Iran, Israel, Tunisia, and Ukraine). Data on socio-demographic and disease characteristics, current symptomatology, and pharmacological treatment were collected. Comparisons between groups were performed using standard statistical tests. Overall, 1180 patients were included. The median time from initial diagnosis was 80 months. Major depressive disorder was the most common initial diagnosis. Mood stabilizers and antipsychotics were the most common drugs being prescribed at the time of the study. Antidepressants (mainly selective serotonin uptake inhibitors [SSRIs]) were administered to 36.1% of patients. Patients with bipolar I disorder received higher number of antipsychotics and anxiolytics than those with bipolar II disorder (p < 0.001). Presence of depressive symptoms was associated with an increase in antidepressant use (p < 0.001). Bipolar disorder real-life management practice, irrespective of region, shows a delay in diagnosis and an overuse of antidepressants. Clinical decision-making appears to be based on a multidimensional approach related to current symptomatology and type of bipolar disorder.
authors.affiliation: CHU Clermont-Ferrand, EA7280, University of Auvergne, Clermont-Ferrand, France.|Bipolar Disorder Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain.
authors.forename: Ludovic
authors.initials: L
authors.lastname: Samalin
authors.affiliation: Bipolar Disorder Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain.
authors.forename: Eduard
authors.initials: E
authors.lastname: Vieta
authors.affiliation: Institute of Psychiatry, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
authors.forename: Tarek Ahmed
authors.initials: TA
authors.lastname: Okasha
authors.affiliation: National Institute of Neurosciences and Hospital, Sher-e-Bangla Nagar, Dhaka, Bangladesh.
authors.forename: Mm Jalal
authors.initials: MJ
authors.lastname: Uddin
authors.affiliation: Roozbeh Hospital, South Kargar Street, Tehran, Iran.
authors.forename: Seyed Ali
authors.initials: SA
authors.lastname: Ahmadi Abhari
authors.affiliation: Psychiatric Department, Razi Hospital, Manouba, Tunisia.
authors.forename: Fethi
authors.initials: F
authors.lastname: Nacef
authors.affiliation: Kyiv City Clinical Psycho-neurological Hospital, Kiev, Ukraine.
authors.forename: Vyacheslav
authors.initials: V
authors.lastname: Mishyiev
authors.affiliation: Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
authors.forename: Dovi
authors.initials: D
authors.lastname: Aizenberg
authors.affiliation: Sha'ar Menashe Mental Health Center (MHC), Technion Institute of Technology, Haifa, Israel.
authors.forename: Yaël
authors.initials: Y
authors.lastname: Ratner
authors.affiliation: Biostatistician, Experis IT, Nanterre, France.
authors.forename: Lydie
authors.initials: L
authors.lastname: Melas-Melt
authors.affiliation: Sanofi, Avenue Raspail, Gentilly, France.
authors.forename: Idir
authors.initials: I
authors.lastname: Sedeki
authors.affiliation: CHU Clermont-Ferrand, EA7280, University of Auvergne, Clermont-Ferrand, France.
authors.forename: Pierre Michel
authors.initials: PM
authors.lastname: Llorca
mesh_terms: D000328:Adult; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D001714:Bipolar Disorder / Q000175:diagnosis* / Q000188:drug therapy*; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D039721:Diagnostic and Statistical Manual of Mental Disorders; D019468:Disease Management; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D061665:Time-to-Treatment
chemical_list: D014150:Antipsychotic Agents