Treatment adherence towards prescribed medications in bipolar-II acute depressed patients: Relationship with cyclothymic temperament and ¡°therapeutic sensation seeking¡± in response towards subjective intolerance to pain

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• 作者：Michele Fornaro ; Domenico De Berardis ; Felice Iasevoli ; Maria Luisa Pistorio ; Emanuela D'Angelo ; Sergio Mungo ; Matteo Martino ; Antonio Ventriglio ; Carlo Ignazio Cattaneo ; Ettore Favaretto ; Aless ; ro Del Debbio ; Anna Romano ; Giovanni Ciampa ; Mai Elassy ; Giulio Perugi ; Concetta De Pasquale
• 关键词：Treatment adherence ; Bipolar disorder ; Acute depression ; Sensation seeking ; Cyclothymic temperament
• 刊名：Journal of Affective Disorders
• 出版年：2013
• 出版时间：November, 2013
• 年：2013
• 卷：151
• 期：2
• 页码：596-604
• 全文大小：601 K

文摘

Background

Treatment adherence (TA) is crucial during almost any phase of bipolar disorder (BD), including type-II (BD-II) acute depression. While a number of issues have been traditionally accounted on the matter, additional factors should be likewise involved, including affective temperaments and some clinically suggestive psychopathological traits whose systematic assessment represents the aim of this study.

Methods

Two hundred and twenty BD-II acute depressed outpatients were consecutively evaluated using the Structured Clinical Interviews for Diagnostic and Statistical Manual for Mental Disorders-Fourth Edition Axis-I and II Disorders, Hamilton scales for Depression and Anxiety, Temperament Evaluation of the Memphis Pisa Paris San Diego-Auto-questionnaire-110-item, Visual Analogue Scale (VAS), Zuckerman's Sensation-Seeking Scale-Form-V (SSS-V), Barratt's Impulsivity Scale-11-item, State-Trait Anxiety Inventory modules, Severity module of the Clinical Global Impression Scale for BD, Morisky 8-Item Medication Adherence Scale (MMAS-8) and the Clinician Rating Scale (CRS). Patients were divided into non-adherent vs. treatment-adherent cases depending on MMAS-8+CRS scores.

Results

In the TA^? group, higher VAS and cyclothymic temperament scores were highly correlated (r=.699; p¡Ü.001). Those latter scores, along with SSS-V scores and the occurrence of lifetime addiction to painkiller and/or homeopathic medications available over the counter defined a ¡°therapeutic sensation seeking¡± pattern allowing to correctly classify as much as 93.9 % [Exp(B)=3.490; p¡Ü.001] of TA^? cases (49/220).

Limits

Lack of objective TA measures and systematic pharmacological record; recall bias on some diagnoses; and relatively small sample size.

Conclusions

Stating the burden of TA in BD, additional studies on this regard are aimed, ideally contributing to enhance the management of BD itself.