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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 |
| Relation | -1006864312617745310, 600, 600, 600, 1545772475950486338, 8765449414823306929, Akiskal, H.S.,Bourgeois, M.L., Angst, J.,Post, R., Moller, H., Hirschfeld, R., 2000. Reevaluatingtheprevalence ofand diagnosticcomposition within thebroadclinical spectrum ofbipolardisorders.Journal ofaffectivedisorders 59Suppl 1, S5-S30. Angst, J., 1998. Theemergingepidemiologyofhypomaniaand bipolar IIdisorder.Journal ofaffectivedisorders 50, 143-151. Angst, J., Gamma, A., Lewinsohn, P., 2002. Theevolvingepidemiologyof bipolardisorder. World psychiatry: official journal oftheWorld PsychiatricAssociation 1, 146-148. Baldassano, C.F., Marangell, L.B.,Gyulai, L., Ghaemi, S.N.,Joffe, H., Kim, D.R., Sagduyu, K., Truman, C.J.,Wisniewski, S.R., Sachs, G.S.,Cohen, L.S., 2005. Genderdifferences in bipolardisorder: retrospectivedatafrom thefirst 500STEP-BD participants.Bipolar disorders 7, 465-470. Baldessarini, R.J., Bolzani, L., Cruz, N., Jones, P.B., Lai, M., Lepri, B., Perez, J., Salvatore, P., Tohen, M., Tondo, L., Vieta, E., 2010. Onset-age of bipolar disorders at six international sites.Journal ofaffectivedisorders 121, 143-146. Benazzi, F., 2007.Bipolar IIdisorder: epidemiology, diagnosis andmanagement. CNS drugs 21, 727-740. Brady, K.T.,Sonne,S.C., 1995. Therelationship between substanceabuseand bipolar disorder. TheJournal ofclinical psychiatry56Suppl 3, 19-24. Brown, A., Bao, Y., McKeague, I.,Shen, L.,Schaefer, C., 2013. Parental ageandrisk of bipolardisorderin offspring.Psychiatryresearch 208, 225-231. Cassidy,F., Ahearn, E.P., Carroll, B.J., 2001.Substanceabusein bipolardisorder. Bipolar disorders 3, 181-188. Castelo, M.S.,Hyphantis, T.N., Macedo, D.S., Lemos, G.O., Machado, Y.O., Kapczinski, F., McIntyre, R.S., Carvalho, A.F., 2012.Screeningforbipolardisorderin theprimarycare: aBrazilian survey.Journal ofaffectivedisorders 143, 118-124. Crow, T.J., 1998.From Kraepelin to KretschmerleavenedbySchneider: thextransition from categories ofpsychosis to dimensions ofvariation intrinsicto homo sapiens. Archives of general psychiatry55, 502-504. Diflorio, A.,Jones, I., 2010. Is sex important? Genderdifferences in bipolardisorder. International review ofpsychiatry22, 437-452. Duffy, A., Alda, M., Crawford, L., Milin, R., Grof,P., 2007. Theearlymanifestations of bipolardisorder: alongitudinal prospectivestudyoftheoffspringofbipolarparents. Bipolar disorders 9, 828-838. Duffy, A., Alda, M., Hajek, T.,Sherry,S.B., Grof,P., 2010. Earlystages in thedevelopment ofbipolardisorder.Journal ofaffectivedisorders 121, 127-135. Fitzgerald, F., 1981. The great imitator,syphilis. TheWestern journal ofmedicine134, 424432. Freeman, M.P.,Freeman, S.A., McElroy,S.L., 2002. Thecomorbidityofbipolarandanxiety disorders: prevalence, psychobiology,and treatment issues.Journal ofaffectivedisorders 68, 1-23. Fusar-Poli, P., Abbamonte, M., Borgwardt, S., 2008. Differential diagnosis between the earlyonset ofschizophreniaand bipolardisorder: potential roleofneuroimaging. CNS spectrums 13, 363-364. Goes, F.S., McCusker,M.G.,Bienvenu, O.J., Mackinnon, D.F., Mondimore,F.M., Schweizer,B.,National InstituteofMental Health Genetics Initiative BipolarDisorder, C., Depaulo, J.R., Potash,J.B., 2012. Co-morbid anxietydisorders in bipolar disorderand major depression: familial aggregation andclinical characteristics ofco-morbid panicdisorder, social phobia, specificphobiaand obsessive-compulsivedisorder.Psychological medicine 42, 1449-1459. Hendrick, V., Altshuler,L.L., Gitlin, M.J., Delrahim, S., Hammen, C., 2000. Genderand bipolarillness. TheJournal ofclinical psychiatry61, 393-396; quiz 397. Hilty, D.M., Leamon, M.H., Lim, R.F.,Kelly, R.H., Hales, R.E., 2006. Areview ofbipolar disorderin adults. Psychiatry3, 43-55. Hirschfeld, R.M., Lewis, L., Vornik, L.A., 2003. Perceptions and impact ofbipolardisorder: howfarhavewereallycome? Results ofthenational depressiveand manic-depressive association 2000 surveyofindividuals with bipolardisorder.TheJournal ofclinical psychiatry64, 161-174. Klassen, L.J., Katzman, M.A., Chokka,P., 2010. Adult ADHDand its comorbidities, with a focus on bipolar disorder.Journal ofaffectivedisorders 124, 1-8. Lish, J.D., Dime-Meenan,S.,Whybrow,P.C., Price, R.A., Hirschfeld, R.M., 1994. The National Depressiveand Manic-depressiveAssociation (DMDA) surveyof bipolar members.Journal ofaffectivedisorders 31, 281-294. Lopes, C.S., Faerstein, E., Chor, D.,Werneck, G.L., 2008. Higherrisk ofcommon mental disorders afterexperiencingphysical violencein Rio deJaneiro,Brazil: thePro-Saude Study. The International journal ofsocial psychiatry54, 112-117. McIntyre, R.S., Konarski,J.Z.,Soczynska,J.K.,Wilkins, K., Panjwani, G.,Bouffard, B., Bottas, A., Kennedy,S.H., 2006. Medical comorbidityin bipolardisorder: implications for functional outcomes andhealth serviceutilization.Psychiatricservices 57, 1140-1144. Moreno, C., Laje, G., Blanco, C.,Jiang, H.,Schmidt, A.B., Olfson, M., 2007. National trends in theoutpatient diagnosis andtreatment of bipolardisorderin youth. Archives of general psychiatry64, 1032-1039. Pacchiarotti, I., Di Marzo, S., Colom, F.,Sanchez-Moreno,J., Vieta, E., 2009.Bipolar disorderprecededbysubstanceabuse: adifferent phenotypewith not so poor outcome? The world journal ofbiological psychiatry: theofficial journal oftheWorld Federation of Societies ofBiological Psychiatry10, 209-216. Paris,J., Gunderson,J.,Weinberg, I., 2007. Theinterfacebetween borderlinepersonality disorderand bipolarspectrum disorders. Comprehensivepsychiatry48, 145-154. Perlis, R.H., 2005. Misdiagnosis ofbipolardisorder. TheAmerican journal ofmanaged care 11,S271-274. Perlis, R.H., Miyahara,S., Marangell, L.B.,Wisniewski, S.R., Ostacher,M., DelBello, M.P., Bowden, C.L., Sachs, G.S., Nierenberg, A.A., Investigators, S.-B., 2004. Long-term implications ofearlyonset in bipolardisorder: datafrom thefirst 1000 participants in the systematictreatment enhancement program forbipolardisorder(STEP-BD).Biological psychiatry55, 875-881. Rubinsztein,J.S., Michael, A., Paykel, E.S.,Sahakian,B.J., 2000. Cognitiveimpairment in remission in bipolaraffectivedisorder.Psychological medicine30, 1025-1036. jelstad, D.V., Malt, U.F., Holte, A., 2010.Symptoms and signs oftheinitial prodromeof bipolardisorder: asystematicreview.Journal ofaffective disorders 126, 1-13. Tamam, L., Karakus, G., Ozpoyraz, N., 2008. Comorbidityofadult attention-deficit hyperactivitydisorderand bipolardisorder: prevalenceandclinical correlates. European archives ofpsychiatryandclinical neuroscience258, 385-393. Tavormina, G., 2011.Aresomatisationsymptoms important evidenceforanearlydiagnosis ofbipolarspectrum mood disorders? Psychiatria Danubina23Suppl 1, S13-14. Thompson, K.N., Conus, P.O., Ward, J.L., Phillips, L.J., Koutsogiannis, J., Leicester, S., McGorry, P.D., 2003. The initial prodrome to bipolar affective disorder: prospective case studies.Journal ofaffectivedisorders 77, 79-85. Thornicroft, G., Rose, D., Kassam, A., Sartorius, N., 2007.Stigma: ignorance, prejudiceor discrimination? TheBritish journal ofpsychiatry: thejournal ofmental science190, 192193. Wingo, A.P., Ghaemi, S.N., 2007. Asystematicreview ofrates and diagnosticvalidityof comorbid adult attention-deficit/hyperactivitydisorderand bipolardisorder. TheJournal of clinical psychiatry68, 1776-1784. |
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