생물정신의학 (Korean Journal of Biological Psychiatry)

  • 제23권4호
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  • Pages.185-192
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  • 2016
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  • 1225-8709(pISSN)
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  • 2005-7571(eISSN)
대한생물정신의학회 (The Korean Society of Biological Psychiatry)
권호 표지

1형 양극성 장애 환자에서 리튬과 발프로산의 장기간 치료 효과에 대한 후향적 평가 : 2년 이상 치료받은 환자의 효과 비교

Long-Term Treatment Response to Lithium and Valproate in Patients with Bipolar 1 Disorder Treated More Than 2 Years : A Retrospective Study

  • 안성우 (삼성서울병원 정신건강의학과) ;
  • 양소영 (삼성서울병원 정신건강의학과) ;
  • 최유진 (삼성생명과학연구소) ;
  • 홍경수 (삼성서울병원 정신건강의학과)
  • Ahn, Sung Woo (Department of Psychiatry, Samsung Medical Center) ;
  • Yang, So-Yung (Department of Psychiatry, Samsung Medical Center) ;
  • Choi, Yujin (Center for Clinical Research, Samsung Biomedical Research Institute) ;
  • Hong, Kyung Sue (Department of Psychiatry, Samsung Medical Center)
  • 투고 : 2016.07.05
  • 심사 : 2016.10.04
  • 발행 : 2016.11.30
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초록

Objectives Treatment response of bipolar disorders (BDs) to long-term mood stabilizers maintenance has not been well explored because of complicated clinical and treatment courses. This study aims at investigating long-term clinical response of BDs to lithium and/or valproate in a naturalistic setting of a tertiary-care university-affiliated hospital. Methods Subjects were 65 patients with bipolar I (BD-I) disorders who had been treated with lithium and/or valproate for more than two years at single bipolar disorder clinic. Long-term response to the best treatment based on treatment algorithms and the current clinical standard of care was retrospectively evaluated using the Alda Scale and the Clinical Global Impression Scale for use in bi-polar illness (CGI-BP). Patients were classified into full responder and partial/non responder groups based on the total score of the Alda Scale with the cut-off score generated from the frequentist mixture analysis of the authors' previous study. Results The mean duration of treatment with the index medication was 69.2 months. Baseline demographic and clinical characteristics were not different among three mood stabilizer groups (valproate, lithium, and combination groups). Twenty-one subjects were classified into full responder group (32.3%). Treatment response assessed by the Alda Scale and CGI-BP scores was not different between lithium and valproate groups. The Alda Scale scores were well correlated with the CGI-BP scores (p < 0.05). Conclusions One third of the patients showed a full response to the long-term lithium and/or valproate treatment in BD-I. The degree of response was similar between lithium and valproate groups.

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참고문헌

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