A clinical staging model for bipolar disorder: longitudinal approach.

Data de publicació: 29/01/2020 Data Ahead of Print: 29/01/2020

Autors de IIS La Fe

Pilar Sierra San Miguel

Autor
Ana Cristina García Blanco

Autor

Autors aliens a IIS La Fe

de la Fuente-Tomás L
Sanchez-Autet M
Arranz B
Safont G
García-Portilla MP

Grups d'Investigació

Investigación en Salud Mental

Leader

Ana Cristina García Blanco

Abstract

Bipolar disorder (BD) has been identified as a life-course illness with different clinical manifestations from an at-risk to a late stage, supporting the assumption that it would benefit from a staging model. In a previous study, we used a clustering approach to stratify 224 patients with a diagnosis of BD into five clusters based on clinical characteristics, functioning, cognition, general health, and health-related quality of life. This study was design to test the construct validity of our previously developed k-means clustering model and to confirm its longitudinal validity over a span of 3 years. Of the 224 patients included at baseline who were used to develop our model, 129 (57.6%) reached the 3-year follow-up. All life domains except mental health-related quality of life (QoL) showed significant worsening in stages (p < 0.001), suggesting construct validity. Furthermore, as patients progressed through stages, functional decline (p < 0.001) and more complex treatment patterns (p = 0.002) were observed. As expected, at 3 years, the majority of patients remained at the same stage (49.6%), or progressed (20.9%) or regressed (23.3%) one stage. Furthermore, 85% of patients who stayed euthymic during that period remained at the same stage or regressed to previous stages, supporting its longitudinal validity. For that reason, this study provides evidence of the construct and longitudinal validity of an empirically developed, comprehensive staging model for patients with BD. Thus, it may help clinicians and researchers to better understand the disorder and, at the same time, to design more accurate and personalized treatment plans.

Dades de la publicació

ISSN/ISSNe:: 2158-3188, 2158-3188
Tipus:: Article
Pàgines:: 45-45
DOI:: 10.1038/s41398-020-0718-9
PubMed:: 32066710
Factor d'Impacte:: 2,652 SCImago ℠
Quartil:: Q1 SCImago ℠

Documents

No hi ha documents

Mètriques

Filiacions

de la Fuente-Tomás L:: Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.

Department of Psychiatry, University of Oviedo, Oviedo, Spain.

Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain.

Instituto de Neurociencias del Principado de Asturias (INEUROPA), Oviedo, Spain.
Sierra P:: La Fe University and Polytechnic Hospital and University of Valencia, Valencia, Spain
Sanchez-Autet M:: Parc Sanitari Sant Joan de Deu, Barcelona, Spain
Arranz B:: Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain

Parc Sanitari Sant Joan de Deu, Barcelona, Spain
García-Blanco A:: La Fe University and Polytechnic Hospital and University of Valencia, Valencia, Spain
Safont G:: Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain

University Hospital Mutua Terrassa, University of Barcelona, Barcelona, Spain
García-Portilla MP:: Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain

Department of Psychiatry, University of Oviedo, Oviedo, Spain

Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain

Instituto de Neurociencias del Principado de Asturias (INEUROPA), Oviedo, Spain

Mental Health Services of Principado de Asturias (SESPA), Oviedo, Spain