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Previous issue date: 2013-09-30 / There are several studies on the differential diagnosis of Bipolar Disorder (BD), however,
further investigation with an emphasis on clinical phenotypes that inaugurate the disease is
needed. The aims of this study are to identify the psychiatric disorders most frequently
diagnosed before the definitive diagnosis of BD, the time until the correct diagnosis and
compare BD I and II for the variables studied. We studied 259 patients with current
diagnosis of BD according to the DSM- IV-TR, evaluated by the same psychiatrist. Early
psychiatric signs and symptoms were identified through an interview with the patient and
family members and were considered suggestive of an initial diagnosis that was coded
according to the same diagnostic criteria. The authors analyzed data on patients' age at
prodromes suggestive of initial psychiatric diagnosis and time delay to the actual diagnosis
of BD. Comparisons were made between sex, schooling and type of BD. The mean age
of patients was 41.6 years, with a predominance of adults (19-60 years), women (67.6%),
as well as type II BD (68.3%). Patients were on average 24.6 years of age at initial
diagnosis, 41.6 years in the diagnosis of BD and the mean time delay between these was
16.9 years. The most common initial diagnoses were depressive disorders (41.3%), anxiety
(12.7%), ADHD (8.1%), disorders related to substance abuse (7.7%), somatoform disorders
(6 9%), and psychosis (5.4%). BD can be considered a “great imitator” in modern
psychiatry, since initial phenotypes can mimic other disorders. BD diagnosis is very
delayed in Brazil. / Há diversos estudos sobre o diagnóstico diferencial do Transtorno Bipolar (TB), entretanto,
investigações com ênfase nos fenótipos clínicos que inauguram a doença são escassos. Os
objetivos deste estudo consistem em identificar as doenças psiquiátricas mais
frequentemente diagnosticadas antes do diagnóstico definitivo de TB, assim como o
intervalo de tempo até o mesmo; e comparar o pacientes com TB I e II quanto aos
diagnósticos iniciais, escolaridade, sexo e faixa etária. Para tanto, estudamos 259 pacientes
com diagnóstico atual de TB segundo os critérios do DSM-IV-TR, realizado por um mesmo
psiquiatra. Através de entrevistas com o paciente e familiares, identificou-se
retrospectivamente os sinais e sintomas precoces considerados sugestivos do primeiro
diagnóstico psiquiátrico, segundo os mesmos critérios. Dados relativos à idade dos
pacientes no diagnóstico inicial e tempo até o diagnóstico atual de TB foram analisados e
comparações foram feitas entre sexo, escolaridade, faixa etária e tipo de TB. A média de
idade encontrada foi de 41,6 anos, com predominância de adultos (19-60 anos), do gênero
feminino (67,6%), com TB II(68,3%). Os pacientes tinham em média 24,6 anos de idade no
diagnóstico inicial, 41,6 anos no diagnóstico de TB e o tempo médio de atraso diagnóstico
foi de 16,9 anos. Os diagnósticos iniciais mais frequentemente encontrados foram:
transtornos depressivos (41,3%), ansiosos (12,7%), TDAH (8,1%), transtornos relacionados
ao abuso de substâncias psicoativas (7,7%), transtornos somatoformes (6,9%) e psicóticos
(5,4%). O T pode ser considerado um “grande imitador” moderno da Psiquiatria, posto que
fenótipos iniciais podem mimetizar outros transtornos. Há um atraso significativo no
diagnóstico do TBno Brasil.
| Identifer | oai:union.ndltd.org:IBICT/oai:repositorio.bc.ufg.br:tde/2913 |
| Date | 30 September 2013 |
| Creators | Chaves, Moysés de Paula Rodrigues |
| Contributors | Caixeta, Leonardo Ferreira |
| Publisher | Universidade Federal de Goiás, Programa de Pós-graduação em Ciências da Saúde (FM), UFG, Brasil, Faculdade de Medicina - FM (RG) |
| Source Sets | IBICT Brazilian ETDs |
| Language | Portuguese |
| Detected Language | English |
| Type | info:eu-repo/semantics/publishedVersion, info:eu-repo/semantics/masterThesis |
| Format | application/pdf |
| Source | reponame:Biblioteca Digital de Teses e Dissertações da UFG, instname:Universidade Federal de Goiás, instacron:UFG |
| Rights | http://creativecommons.org/licenses/by-nc-nd/4.0/, info:eu-repo/semantics/openAccess |
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