Patient´s and psychiatrist´s perspective about side effects in pharmacological treatment in bipolar disorder

STREJILEVICH S.A., SCÁPOLA M., MARTINO D.J., IGOA A., MARENGO E., CALVÓ M.

Santiago, Chile

Congreso; 2nd International Congress of Biological Psychiatry; 2007

Introduction: Background: Patients’ perspective of their pharmacological treatment’s side effects has been strongly related to adherence and long term evolution in many diseases with chronic pharmacological treat- ments. However, there are not previous studies about this critical issue in people under treatment with bipolar disorder. Objective: The aim of this study was to estimate the rate of side effects and its “subjective impact” reported by outpatients with euthymic bipolar disorder and their psychia- trists, as well as to estimate the association of these variables with treat- ment adherence and intention of dropping out. Method: Sixty patients with euthymic bipolar disorder in naturalistic con- ditions of treatment were included, and completed a modified version of the Udvalg for Kliniske Unders/-Egelser (UKU) that estimated presence, intensity, trouble and interference in daily life activities of side effects, as well as adherence to treatment and intention of dropping out through visual analogical scales. Psychiatrists completed the same scale blindly. Results: Patients with BD reported more quantity and intensity of side effects than those reported by their psychiatrists. The presence/intensity of side effects was not necessarily associated with the subjective impact (trouble and interference in daily life activities) of them. Cognitive side effects, as memory and disatenttion complaints, could have a strong sub- jective impact. Quantity and intensity of side effects were not associated with adherence to treatment. There was a negative correlation between subjective impact and adherence to treatment. Conclusion: Psychiatrists could underestimate the record and intensity of side effects in their patients. Trouble ant interference in daily life activities could be better predictors of adherence to treatment than quantity and intensity of side effects. However, subjective impact of side effects could explain a relatively low proportion of variance of treatment adherence and intention of dropping out.