Which factors delay treatment in bipolar disorder? A nationwide study focussed on duration of untreated illness

Abstract

Aim:The aim of the present study was to detect factors associated with duration of untreated illness (DUI) in bipolar disorder (BD).Method: A total of 1575 patients were selected for the purposes of the study. Correlation analyses were performed to analyse the relation between DUI and quantitative variables. The length of DUI was compared between groups defined by qualitative variables through one-way analyses of variance or Kruskal-Wallis's tests according to the distribution of the variable. Linear multivariable regressions were used to find the most parsimonious set of variables independently associated with DUI: to this aim, qualitative variables were inserted with the numeric code of their classes by assuming a proportional effect moving from one class to another.

The psychopathological impact of the SARS-CoV-2 epidemic on subjects suffering from different mental disorders: An observational retrospective study

“…Clinical variables included: diagnosis, age at onset, duration of illness, duration of untreated illness – DUI, level of needed care, type of psychiatric comorbidity, the presence of multiple psychiatric comorbidity (yes/no), the presence of family history of psychiatric disorders, suicide attempts, presence and number of hospitalizations, main pharmacological treatment, the presence of poly-therapy (yes/no), post-COVID changes in psychopharmacological treatment (no/increased/decreased in terms of dosages and/or number of prescribed compounds), presence of ongoing psychotherapy (yes/no). DUI was defined as the time elapsing between the onset of psychiatric disorders and the prescription of a proper pharmacological treatment according to international guidelines ( Buoli et al., 2021 ). Level of needed care was considered “high” when the patient required a team of personnel for care, “low” when the patient was followed only by the psychiatrist.…”

Factors associated with lifetime suicide attempts in bipolar disorder: results from an Italian nationwide study

“…Bipolar disorder (BD) is a widespread and severe psychiatric condition associated with reduced psychosocial functioning and a loss of life expectancy of about 10-20 years with respect to healthy general population, particularly due to suicide and cardiovascular diseases [1]. Different factors were identified as predictors of chronic course and poor outcome in BD, including among others delayed treatment [2], lifetime presence of psychotic symptoms [3,4], rapid cycling [5][6][7], concomitant substance misuse [8], and psychiatric/ medical comorbidity such as borderline personality disorder [9], obesity [10] or diabetes [11]. The identification of clinical predictors of illness severity allowed to a better management of BD, and to develop targeted prevention strategies [12].…”

Predominant Polarity and Polarity Index of Maintenance Treatments for Bipolar Disorder: A Validation Study in a Large Naturalistic Sample in Italy

“…Bipolar disorder (BD) is a highly heterogeneous psychiatric condition in terms of phenotypic expression. This relatively high degree of heterogeneity hinders, on the one hand, the formulation of an accurate diagnosis, which in turn might result in significant delays in prescribing an adequate treatment [1]. On the other, it might lead to a difficulty in selecting the right treatment for the right patient at the right time [2].…”