. Diagnostic delay impact on long-term evolution and fucntional recovery might be mediated by exposure to modd stabilizers.

STREJILEVICH S.A., MARTINO D.J., TEITELBAUM J., FASSI G., MARENGO E., IGOA A., AIS.

Conferencia; Ninth International Conference on Bipolar Disorder; 2011

Introduction: Diagnostic delay (DD) is associated with morehospitalizations and suicidal attempts, worse social and workfunctioning, and poorer quality of life. Nevertheless, due tomethodological limitations, current available data on how DDmay impact in the long-term evolution of bipolar disorder (BD) isnot fully understood. In the present, we explore the impact of DDon the symptomatic course and overall functioning of BDoutpatients during a 3-year follow-up.Methods: Clinical data from 56 bipolar I and II patients wasretrospectively analyzed. Inclusion criteria were: a)>12 months oftreatment in our program with no interruptions, b) euthymia > 8weeks at the time of assessment (< 8 points HAM-D and < 6points YMRS), d) no other Axis I diagnosis except GAD. Courseof illness was weekly assessed by means of the previously reportedlife chart technique and overall functioning by FAST.Pharmacological treatment exposure was assessed by IFD. Ageat illness onset, first contact with mental health professional, timeto diagnosis, and number of previous manic and depressiveepisodes were obtained from clinical charts and patientsinterviews. DD was defined as time elapsed between first contactwith mental health care system because of BD symptoms to themoment such diagnosis was made. Non-parametric comparisonsbetween patients with < 2 years of DD and more were performed.Spearman bivariate correlations were computed to assess therelationship between early clinical parameters and level ofsymptomatic stability and functional recovery achieved duringfollow-up. Linear regression models were used to determine thebest clinical predictors.Results: Patients with longer DD spent significantly less weeks ineuthymia and had worst overall functioning. In a linear regressionmodel with weeks in euthymia as dependent variables, DD lossessignificance when time spent under treatment with mood stabilizersis included.Discussion: Longer DD predicts worst long-term symptomaticprognosis and functional recovery but this e!ect might be mediatedby time exposed to mood stabilizers.