Bipolar Disorder: Strejilevich S

Vázquez GH, Strejilevich S, García Bonetto G, Cetkovich-Bakmas M, Zaratiegui R, Lagomarsino A, Goldchluk A, Kalina E, Herbst L, Gutiérrez B, Anonymous00416. · Departamento de Neurociencias, Universidad de Palermo, Buenos Aires, Argentina. · Vertex. · Pubmed #16601825 No free full text.

Abstract: The consensus guidelines of argentine experts in the treatment of bipolar disorders are the result of three days of work of the 10 main local experts under the organization of the Argentine Association of Biological Psychiatry (AAPB). It was adopted a mixed criterion for its preparation: all the recent data of the evidence medicine based published until now were discussed and were balanced with the knowledge acquired from clinical experience of the local experts on the bipolar field. It presents general recommendations and suggested therapeutic sequences for the phase of maintenance, the manic/hypomanic or mixed episode and the depressive episode. These have been divided according to the classification in type I and II; with or without rapid cycling. Since the group of experts identified the delay and miss-diagnoses like the most important barrier for a suitable treatment enclosed a series of recommendations for differential diagnosis of bipolar disorders.

Strejilevich S. · Hospital Parmenio Piñero, Ciudad de Buenos Aires, Argentina. · Vertex. · Pubmed #11907589 No free full text.

Abstract: Recent studies are showing that prevalence of Bipolar Disorders is higher than traditionally admitted, and that their costs are equal, at least, to those arising from schizophrenia. In our region, these disorders may be considered as an epidemic in the few next years, according the epidemiological approach. Nevertheless, the very few available data in our country show a serious deficit in diagnosis, treatment and information available for the users. In this context, the inertia of government is critical in generating specific policies aimed to control these disorders. Facing this challenge, needed information should be achieved in order to be able of establishing rational policies and strategies thus increasing general information about this problem, involving the users.

Strejilevich S, Retamal Carrasco P. · Area de Investigación y Desarrollo en Salud Mental, Buenos Aires, Argentina. · Vertex. · Pubmed #14654872 No free full text.

Abstract: OBJECTIVE: Early detection and treatment of Bipolar Disorder (BD) determine a significant relief in the considerable burden this disease implies. In order to adequately plan the strategies to guarantee access to treatment, it is useful to consider data which reflect the everyday vicissitudes the people affected by this pathology have to deal with. People on treatment for BD in centres in Argentina and Chile were surveyed, collecting data on their access to diagnosis and treatment. The centre surveyed in Chile, unlike those in Argentina, operates as a specialized unit. METHODOLOGY: An anonymous assisted survey was carried out; a random sample of people assisted in the participating centres with a diagnosis of BD type I or II, and stabilized for a period no shorter than 12 months, was assessed. RESULTS: 100 people were surveyed in Argentina and 69 in Chile (70% women, age 45.2 +/- 14.7, average schooling 12 years). Seventy one percent began symptoms at adult age (28,43 +/- 13 years), 14% during childhood. Age at first consultation was: 30 +/- 12.5; 85% reported having suffered psychotic symptoms, 46.4% suicide attempts, 71% hospitalisations for BD. Sixty-nine percent reported diagnostic delays longer than a year (median 8 years), 75% reported having received other diagnosis prior to their BD diagnosis (62% unipolar depression, 41% schizophrenia). Forty-one percent reported being unemployed. Delays and diagnostic errors were associated to a significant increase in the functional impact reported. CONCLUSION: Approximately 7 out of 10 people report difficulties in the access to a BD diagnosis. These difficulties magnify the already important impact of the disease.

Strejilevich S, Chan M, Triskier F, Orgambide S. · Servicio de Psicopatología del Hospital General de Agudos P. Piñero, Buenos Aires, Argentina. · Vertex. · Pubmed #12192417 No free full text.

Abstract: The epidemiological projections show that the problems of Mental Health were the main health challenge during the last decade. This situation is particularly worring in our region. The poor operative data in relation to the care of the mental disorders prevent the elaboration of plans on the basis of secure data. METHODOLOGY: Records of externation were analized during the period between 1994-1998 in the men Psychiatric Internation Unity in the Psychopatology Service of the Hospital Piñero in Buenos Aires, which is part of the public health service of the city. RESULTS: an average time of internation of 42.8 days was reported (SD 40,3), which was higher than the 11 days reported in institutions of the private health services. An increasing proportional diagnosis of Bipolar Disorder was reported (chi square corresponding to tendencies P<0.01, lineality P<0.001) and a significative decline in the number of diagnosis of Schizophrenia (chi square corresponding to tendencies P<0.05; lineality P<0.05). In this way, the ratio of the diagnosis of Schizophrenia and Bipolar Disorder changed from 7:1 in 1994 to 1,7:1 in 1998. CONCLUSIONS: A variation in the diagnostic habits was observed, suggesting that affective disorders were underdiagnosticated. This tendency was corrected latter. Similar remarks made by other services in the same region support this interpretation of the data.

Strejilevich S, Garcia Bonetto G. · No affiliation provided · J Affect Disord. · Pubmed #14607397 No free full text.

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