Project Summary

Leonardo Tondo, M.D. (Independent Investigator 2003) of Harvard University, will evaluate effects of short-term treatments in acute episodes of mania or hypomania (antipsychotic or antimanic agents), or bipolar major depression (antidepressants), or maintained long-term mood-stabilizing treatments (typically with lithium carbonate, and less often with carbamazepine or sodium valproate). The effects of the treatments will be evaluated on the course of the bipolar disorder, including episode type, severity, duration, number of episodes and rate. Comparisons will involve the same patients before and during dissimilar treatments as well as those who receive the different types of treatments. The study should clarify characteristics of patients who elect or are chosen for one treatment strategy or the other. The study is based on a new database and electronic medical record (EMR) that includes variables of interest for each month, and derived from illness datasheets and charts that have been used for all patients since their intake into the mood disorder clinic, Centro Bini, in Cagliari, Sardinia, since 1977. This database records the patient's mood status (euthymia, manic, depressive, mixed), mood severity (mild, moderate, severe depression; hypomania, mania, hospitalization), mood modifiers (psychotic features, mixed states, and melancholia), and treatments (categorized as antidepressants, antipsychotics, mood stabilizers). Other available variables of interest are: sex, marital status, education, employment, family history, diagnosis, type of polarity at first episode, age at illness onset, at intake, at the start of the therapy; follow-up, type of treatment and its duration, suicidal behavior, and substance use disorder. Dr. Tondo will seek information on: modifications of morbidity associated with the treatments provided, course patterns according to the more prevalent episode sequences (mania-depression-interval, depression-mania-interval, circular), seasonality in specific clinical subgroups, differences between patients who adhere to treatment and those who modify or discontinue treatment. This information should help to guide treatment strategies for patients with different clinical and demographic characteristics.

Program Area: MOOD DISORDERS\Bipolar

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