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Prescribing patterns of antidepressants, antipsychotics and mood stabilizers in bipolar patients misdiagnosed with major depressive disorder in China
Xiang Y.-T.9; Hu C.3; Wang G.3; Zheng Q.-W.1; Fang Y.-R.10; Ungvari G.S.8; Kilbourne A.M.13; Lai K.Y.C.9; Si T.-M.1; Chen D.-F.1; Lu Z.16; Yang H.-C.2; Hu J.5; Chen Z.-Y.4; Huang Y.14; Sun J.6; Wang X.-P.15; Li H.-C.11; Zhang J.-B.12; Chiu H.F.K.9
2012-11-01
Source PublicationHuman Psychopharmacology
ISSN08856222 10991077
Volume27Issue:6Pages:626-631
AbstractObjective Bipolar disorder (BD) is frequently misdiagnosed as major depressive disorder (MDD), which may lead to inappropriate treatment and poor outcomes. This study aimed to examine prescribing patterns of antidepressants, antipsychotics and mood stabilizers in BD patients misdiagnosed with MDD in China. Methods A total of 1487 patients originally diagnosed with MDD were consecutively screened for diagnostic revision in 13 psychiatric hospitals or psychiatric units of general hospitals in China nationwide. The patients' sociodemographic and clinical characteristics were recorded using a standardized protocol and data collection procedure. The Mini International Neuropsychiatric Interview (MINI) was used to establish DSM-IV diagnoses. Data on psychotropic prescriptions were collected by a review of medical records. Results Three hundred and nine of the 1487 patients (20.8%) fulfilled DSM-IV criteria for BD; 118 (7.9%) for BD-I and 191 (12.8%) for BD-II on the MINI. Of the BD patients (n = 309), 227 (73.5%) received any use of antidepressants, 73 (23.6%) antipsychotics and 33 (10.7%) mood stabilizers. In multiple logistic regression analyses, compared with those with MDD, patients with BD-I were more likely to receive antidepressants (OR 1.7, 95% CI 1.1-2.8, p = 0.02), antipsychotics (OR 1.6, 95% CI 1.04-2.5, p = 0.04) and mood stabilizers (OR 3.9, 95% CI 2.1-7.2, p < 0.001), whereas patients with BD-II were more likely to receive mood stabilizers (OR 2.4, 95% CI 1.3-4.4, p = 0.003). There was no difference in the use of antidepressants (OR 1.1, 95% CI 0.8-1.5, p = 0.7) and antipsychotics (OR 1.3, 95% CI 0.9-1.9, p = 0.2) between BD-II and MDD. In addition, there was no difference between BD-I and BD-II in any use of antidepressants, antipsychotics and mood stabilizers. Conclusions The prescription of antidepressants for BD patients misdiagnosed with MDD is very common, and only a very small proportion of patients received guideline-concordant treatment. Considering the potentially hazardous effects of inappropriate pharmacotherapy in this population, continuing education and training addressing the correct diagnosis of BD and rational use of psychotropic medications are needed in China. Copyright © 2012 John Wiley & Sons, Ltd. Copyright © 2012 John Wiley & Sons, Ltd.
Keywordbipolar disorder major depressive disorder prescription patterns
DOI10.1002/hup.2262
URLView the original
Language英語
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Cited Times [WOS]:6   [WOS Record]     [Related Records in WOS]
Document TypeJournal article
CollectionFaculty of Health Sciences
Affiliation1.Peking University
2.Shenzhen Mental Health Centre
3.Beijing An Ding Hospital, Capital Medical University
4.Hangzhou Seventh People's Hospital
5.Harbin Medical University
6.Nanjing Medical University
7.University of Michigan Medical School
8.University of Western Australia
9.Chinese University of Hong Kong
10.Shanghai Jiao Tong University
11.Zhejiang University
12.Sun Yat-Sen University
13.Veterans Administration
14.West China Hospital of Sichuan University
15.Second Xiangya Hospital of Central-South University
16.Tongji University
Recommended Citation
GB/T 7714
Xiang Y.-T.,Hu C.,Wang G.,et al. Prescribing patterns of antidepressants, antipsychotics and mood stabilizers in bipolar patients misdiagnosed with major depressive disorder in China[J]. Human Psychopharmacology,2012,27(6):626-631.
APA Xiang Y.-T..,Hu C..,Wang G..,Zheng Q.-W..,Fang Y.-R..,...&Chiu H.F.K..(2012).Prescribing patterns of antidepressants, antipsychotics and mood stabilizers in bipolar patients misdiagnosed with major depressive disorder in China.Human Psychopharmacology,27(6),626-631.
MLA Xiang Y.-T.,et al."Prescribing patterns of antidepressants, antipsychotics and mood stabilizers in bipolar patients misdiagnosed with major depressive disorder in China".Human Psychopharmacology 27.6(2012):626-631.
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