ISSN 1302-6631
 

Original Research (Original Article) 


A cross-sectional analysis of patient characteristics and practice patterns in the management of bipolar disorder across Turkey

Mustafa Bilici, Sermin Kesebir, Evrim Özkorumak, Ömer Yanartaş, Sema İşitmez.

Abstract
Objective: Bipolar disorder (BD) is one of the leading causes of disability among medical and psychiatric disorders associated with prevalent, chronic, severe and highly disabling characteristics. This study was designed to identify clinical characteristics and practice patterns in the management of outpatients with BD across Turkey. Methods: This multi-center cross-sectional study involving 1001 patients diagnosed with using DSM-IV criteria was conducted prospectively at 31 outpatient psychiatry clinics for 12 months. Patient demographics, clinical features, family history, comorbid psychiatric disorders, and the treatment modalities were assessed by means of semi-structured questionnaire.
Results: Age at the onset of symptoms was 26.7±9.8 years, age at diagnosis was 28.9±10.4 years, and the time interval between them was 2.2 (4.7) years. Misdiagnosis prior to current diagnosis was evident in 40.3% of bipolar patients. The most common type of first episode was mania (57.1%) and depression (34.5%). Comorbid psychiatric illness was identified in 12.0% of patients. Only 10% of patients were receiving monotherapy. The most commonly prescribed drugs for depressive, manic and mixed episodes were lithium, sodium valproate and quetiapine, respectively. Conclusion: The time interval between onset of symptoms and the initial diagnosis in Turkish sample was quite shorter than reported in the literature. The misdiagnosis rate in the present study and recent studies were similar. A low comorbidity rate appears to indicate a lower prevalence of comorbid disorders in BD in Turkish sample. Lithium, sodium valproate and atypical antipsychotics were more commonly used drugs in the treatment of BD in Turkey.

Key words: Clinical practice pattern, bipolar disorder, disease management, medical practice, Turkey



Türkiye’de bipolar bozukluğun ele alınmasında pratik uygulamalar ve hasta özelliklerinin kesitsel incelenmesi

Ozet
Amaç: Bipolar bozukluk (BB), tıbbi ve ruhsal bozukluklar arasında önemli yeti yitimine yol açan yaygın, kronik bir hastalıktır. Bu çalışma Türkiye’de ayaktan izlenen hastaların klinik özellikleri ve pratik örüntülerini belirlemek amacıyla planlanmıştır. Yöntem: Çok merkezli kesitsel olan bu çalışmaya 12 ay içinde ayaktan psikiyatri hizmetleri veren 31 kliniğe başvuran DSM-IV ölçütlerine göre tanı konan 1001 hasta alınmıştır. Hastaların demografik, klinik özellik, aile öyküsü, eşlik eden ruhsal bozukluklar ve tedavi modaliteleri yarı yapılandırılmış bir anketle değerlendirilmiştir. Bulgular: Bozukluğun başlangıç yaşı 26.7±9.8, tanı aldığı yaş 28.9±10.4 ve ikisinin arasındaki süre 2.2±4.7 yıldır. Şu anki tanıdan önce yanlış tanı konma oranı %40.3’tür. En sık ilk nöbet tipi mani (%57.1) ve depresyondur (%34.5). Eşlik eden ruhsal bozukluk hastaların %12’sinde saptanmıştır. Hastaların yalnız %10’u monoterapi almaktadır. En sık reçete edilen ilaçlar depresif, manik ve karma nöbetler için sırasıyla lityum, sodyum valproat ve ketiyapindir. Sonuç: Türkiye’deki örneklemde belirtilerin başlangıcı ve ilk tanı konma arasındaki süre daha önce yapılan çalışmalarda bildirilen sürelerden kısadır. Yanlış tanı konma oranları daha önce yapılan çalışmalarla benzerdir. Eşlik eden ruhsal bozukluk oranının düşük çıkması Türk toplumu örnekleminde eşlik eden ruhsal bozukluk yaygınlığının düşük olması ile ilişkilidir. Lityum, sodyum valproat ve atipik antipsikotikler Türkiye’de en sık kullanılan ilaç tedavilerdir.

Anahtar Kelimeler: Klinik pratik, bipolar bozukluk, hastalığın ele alınması, tıbbi pratik, Türkiye


 
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How to Cite this Article
Pubmed Style

Bilici M, Kesebir S, Ozkorumak E, Yanartas O, Isitmez S. [A cross-sectional analysis of patient characteristics and practice patterns in the management of bipolar disorder across Turkey]. Anadolu Psikiyatri Derg. 2014; 15(4): 304-312. Turkish. doi:10.5455/apd.152521


Web Style

Bilici M, Kesebir S, Ozkorumak E, Yanartas O, Isitmez S. [A cross-sectional analysis of patient characteristics and practice patterns in the management of bipolar disorder across Turkey]. http://www.anadolupsikiyatri.net/?mno=152521 [Access: July 21, 2018]. Turkish. doi:10.5455/apd.152521


AMA (American Medical Association) Style

Bilici M, Kesebir S, Ozkorumak E, Yanartas O, Isitmez S. [A cross-sectional analysis of patient characteristics and practice patterns in the management of bipolar disorder across Turkey]. Anadolu Psikiyatri Derg. 2014; 15(4): 304-312. Turkish. doi:10.5455/apd.152521



Vancouver/ICMJE Style

Bilici M, Kesebir S, Ozkorumak E, Yanartas O, Isitmez S. [A cross-sectional analysis of patient characteristics and practice patterns in the management of bipolar disorder across Turkey]. Anadolu Psikiyatri Derg. (2014), [cited July 21, 2018]; 15(4): 304-312. Turkish. doi:10.5455/apd.152521



Harvard Style

Bilici, M., Kesebir, S., Ozkorumak, E., Yanartas, O. & Isitmez, S. (2014) [A cross-sectional analysis of patient characteristics and practice patterns in the management of bipolar disorder across Turkey]. Anadolu Psikiyatri Derg, 15 (4), 304-312. Turkish. doi:10.5455/apd.152521



Turabian Style

Bilici, Mustafa, Sermin Kesebir, Evrim Ozkorumak, Omer Yanartas, and Sema Isitmez. 2014. [A cross-sectional analysis of patient characteristics and practice patterns in the management of bipolar disorder across Turkey]. Anatolian Journal of Psychiatry, 15 (4), 304-312. Turkish. doi:10.5455/apd.152521



Chicago Style

Bilici, Mustafa, Sermin Kesebir, Evrim Ozkorumak, Omer Yanartas, and Sema Isitmez. "[A cross-sectional analysis of patient characteristics and practice patterns in the management of bipolar disorder across Turkey]." Anatolian Journal of Psychiatry 15 (2014), 304-312. Turkish. doi:10.5455/apd.152521



MLA (The Modern Language Association) Style

Bilici, Mustafa, Sermin Kesebir, Evrim Ozkorumak, Omer Yanartas, and Sema Isitmez. "[A cross-sectional analysis of patient characteristics and practice patterns in the management of bipolar disorder across Turkey]." Anatolian Journal of Psychiatry 15.4 (2014), 304-312. Print.Turkish. doi:10.5455/apd.152521



APA (American Psychological Association) Style

Bilici, M., Kesebir, S., Ozkorumak, E., Yanartas, O. & Isitmez, S. (2014) [A cross-sectional analysis of patient characteristics and practice patterns in the management of bipolar disorder across Turkey]. Anatolian Journal of Psychiatry, 15 (4), 304-312. Turkish. doi:10.5455/apd.152521





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