| Title | Guidelines Disconcordance in Acute Bipolar Depression: Data from the National Bipolar Mania Pathway Survey (BIPAS) in Mainland China |
| Authors | Wang, Zuowei Gao, Keming Hong, Wu Xing, Mengjuan Wu, Zhiguo Chen, Jun Zhang, Chen Yuan, Chengmei Huang, Jia Peng, Daihui Wang, Yong Lu, Weihong Yi, Zhenghui Yu, Xin Zhao, Jingping Fang, Yiru |
| Affiliation | Shanghai Jiao Tong Univ, Sch Med, Shanghai Mental Hlth Ctr, Div Mood Disorders,Dept Psychiat, Shanghai 200030, Peoples R China. Hongkou Dist Mental Hlth Ctr Shanghai, Div Mood Disorders, Shanghai, Peoples R China. Case Western Reserve Univ, Sch Med, Univ Hosp Case Med Ctr,Dept Psychiat, Mood & Anxiety Clin,Mood Disorders Program, Cleveland, OH USA. Peking Univ, Inst Mental Hlth, Beijing 100871, Peoples R China. Cent S Univ, Xiangya Hosp 2, Mental Hlth Inst, Changsha, Hunan, Peoples R China. |
| Keywords | PSYCHIATRY WFSBP GUIDELINES TREATMENT ENHANCEMENT PROGRAM BIOLOGICAL TREATMENT DISORDER PATIENTS WORLD FEDERATION STEP-BD SPECTRUM DISORDER CLINICAL-PRACTICE MOOD STABILIZERS COMORBIDITY |
| Issue Date | 2014 |
| Publisher | plos one |
| Citation | PLOS ONE.2014,9,(4). |
| Abstract | With the recent attention to the importance of evidence-based medicine in psychiatry, a number of treatment guidelines have been published. This survey investigated prescribing pattern and predictors for guideline disconcordance in the acute treatment of bipolar depression across mainland China. Pharmacological treatments of 1078 patients with bipolar depression were examined. Guidelines disconcordance was determined by comparing the medication(s) patients were prescribed with the recommendation(s) in the guidelines of the Canadian Network for Mood and Anxiety Treatments. Predictors for guidelines discordance were analyzed with logistic regression. Of the 1078 patients, 50.2% patients were treated against treatment guidelines recommendations. The patients who were treated in general hospitals (OR = 1.53, 95% CI 1.18-1.97), with a depressive episode (OR = 1.67, 95% CI 1.27-2.19) and an older age at first onset (OR = 1.62, 95% CI 1.15-2.28) were more likely to receive guideline-disconcordant treatment than their counterparts. In contrast, the patients with current mental comorbidity, an older age at study entry, a longer duration of disease, and more frequent episodes in past year were less likely to receive guideline-disconcordant treatments than their counterparts with an OR of 0.43 (95% CI 0.24-0.77), 0.52 (95CI% 0.36-0.75), 0.48 (95% CI 0.36-0.65), and 0.50 (95% CI 0.38-0.64), respectively. Our finding suggested the disconcordance with treatment guidelines in patients with an acute bipolar depression is common under naturalistic conditions in mainland China, and the predicting factors correlated with guidelines disconcordance include both psychiatrist-specific (clinicians from general hospitals) and patient-specific features (a depressive episode at first onset, no current co-morbidity with mental disorders, a younger age at study entry, an older age at first onset, shorter duration of disease, and non-frequent episodes in past year). |
| URI | http://hdl.handle.net/20.500.11897/189476 |
| ISSN | 1932-6203 |
| DOI | 10.1371/journal.pone.0096096 |
| Indexed | SCI(E) PubMed SSCI |
| Appears in Collections: | 第六医院 |
