TY - JOUR
T1 - Which factors delay treatment in bipolar disorder? A nationwide study focussed on duration of untreated illness
AU - ISBD Italian Chapter Epidemiologic Group
AU - Buoli, Massimiliano
AU - Cesana, Bruno Mario
AU - Fagiolini, Andrea
AU - Albert, Umberto
AU - Maina, Giuseppe
AU - de Bartolomeis, Andrea
AU - Pompili, Maurizio
AU - Bondi, Emi
AU - Steardo, Luca
AU - Amore, Mario
AU - Bellomo, Antonello
AU - Bertolino, Alessandro
AU - Di Nicola, Marco
AU - Di Sciascio, Guido
AU - Fiorillo, Andrea
AU - Rocca, Paola
AU - Sacchetti, Emilio
AU - Sani, Gabriele
AU - Siracusano, Alberto
AU - Di Lorenzo, Giorgio
AU - Tortorella, Alfonso
AU - Altamura, Alfredo Carlo
AU - Dell'Osso, Bernardo
PY - 2020
Y1 - 2020
N2 - 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. Results: An inverse significant correlation between length of DUI and time between visits in euthymic patients was observed (r = −.52, P <.001). DUI resulted to be longer in patients with: at least one lifetime marriage/partnership (P =.009), a first psychiatric diagnosis of major depressive disorder or substance abuse (P <.001), a depressive polarity of first episode (P <.001), no lifetime psychotic symptoms (P <.001), BD type 2 (P <.001), more lifetime depressive/hypomanic episodes (P <.001), less lifetime manic episodes (P <.001), presence of suicide attempts (P =.004), depressive episodes (P <.001), hypomanic episodes (P =.004), hospitalizations (P =.011) in the last year. Conclusions: Different factors resulted to increase the length of DUI in a nationwide sample of bipolar patients. In addition, the DUI was found to show a negative long-term effect in terms of more suicidal behaviour, more probability of hospitalization and depressive/hypomanic episodes.
AB - 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. Results: An inverse significant correlation between length of DUI and time between visits in euthymic patients was observed (r = −.52, P <.001). DUI resulted to be longer in patients with: at least one lifetime marriage/partnership (P =.009), a first psychiatric diagnosis of major depressive disorder or substance abuse (P <.001), a depressive polarity of first episode (P <.001), no lifetime psychotic symptoms (P <.001), BD type 2 (P <.001), more lifetime depressive/hypomanic episodes (P <.001), less lifetime manic episodes (P <.001), presence of suicide attempts (P =.004), depressive episodes (P <.001), hypomanic episodes (P =.004), hospitalizations (P =.011) in the last year. Conclusions: Different factors resulted to increase the length of DUI in a nationwide sample of bipolar patients. In addition, the DUI was found to show a negative long-term effect in terms of more suicidal behaviour, more probability of hospitalization and depressive/hypomanic episodes.
KW - bipolar disorder (BD)
KW - clinical features
KW - duration of untreated illness (DUI)
KW - outcome
UR - http://www.scopus.com/inward/record.url?scp=85092578021&partnerID=8YFLogxK
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U2 - 10.1111/eip.13051
DO - 10.1111/eip.13051
M3 - Article
AN - SCOPUS:85092578021
JO - Early Intervention in Psychiatry
JF - Early Intervention in Psychiatry
SN - 1751-7885
ER -