Differential prevalence and demographic and clinical correlates of second-generation antipsychotic use in bipolar I versus bipolar II disorder. (May 2016)

• Record Type: Journal Article
• Authors: Park, Dong Yeon; Goffin, Kathryn C.; Shah, Saloni; Yuen, Laura D.; Holtzman, Jessica N.; Hooshmand, Farnaz; Miller, Shefali; Wang, Po W.; Ketter, Terence A.
• Is Part Of: Journal of psychiatric research. Volume 76(2016:May)
• Page Start: 52
• Page End: 58
• Publication Date: 2016-05
• Subjects: Bipolar I disorder -- Bipolar II disorder -- Antipsychotics -- Prevalence -- Demographics -- Clinical correlates; Psychiatry -- Periodicals; Mental Disorders -- Periodicals; Maladies mentales -- Périodiques; Psychiatry; Electronic journals; Periodicals; 616.89005
• DOI: 10.1016/j.jpsychires.2016.01.016
• Languages: English
• ISSNs: 0022-3956

Abstract

Abstract: Aims: To assess second-generation antipsychotic (SGA) use, demographics, and clinical correlates in patients with bipolar I disorder (BDI) versus bipolar II disorder (BDII). Methods: Stanford Bipolar Disorder (BD) Clinic outpatients enrolled during 2000–2011 were assessed with the Systematic Treatment Enhancement Program for BD (STEP-BD) Affective Disorders Evaluation. Current SGA use, demographics, and clinical correlates were assessed for BDI versus BDII. Results: Among 503 BD outpatients, in BDI versus BDII, SGA use was more than twice as common (44.0% versus 21.2%), and doses were approximately twice as high. BDI patients taking (N = 107) versus not taking (N = 136) SGAs less often had current full time employment and college degree; and more often had lifetime psychiatric hospitalization, current depression, and current complex pharmacotherapy, and had a higher mean current Clinical Global Impression for Bipolar Version Overall Severity score, and these persisted significantly after covarying for employment and education. Prior psychiatric hospitalization was the most robust correlate of SGA use in BDI patients. In contrast, these demographic and clinical correlates of SGA use were not statistically significant among patients with BDII, although BDII (but not BDI) patients taking (N = 55) versus not taking (N = 205) SGAs were more likely to have current mood stabilizer use (67.3% versus 51.7%). Limitations: American tertiary bipolar disorder clinic referral sample, cross-sectional design. Conclusions: Current SGA use was robustly associated with prior psychiatric hospitalization in BDI and to a more limited extent with current mood stabilizer use in BDII. SGA use associations with other unfavorable illness characteristics in BDI were less robust. Highlights: Second-generation antipsychotic (SGA) use, demographics, & clinical correlates in bipolar I versus II disorder need study. In bipolar I versus II disorder, SGA use was 100–200% higher, and SGA doses were 60–90% higher. SGA use associated with prior psychiatric hospitalization in bipolar I, & mood stabilizer use in bipolar II disorder.