Hostname: page-component-78c5997874-j824f Total loading time: 0 Render date: 2024-11-16T11:15:33.979Z Has data issue: false hasContentIssue false
  • English
  • Français

Episodios maníacos: el coste directo de un período de tres meses posterior a la hospitalización

Published online by Cambridge University Press:  12 May 2020

J. P. Olié  and
E. Lévy
J. P. Olié
Affiliation:
Centro Hospitalaho de Santa Ana, 1, rue Cabanis, 75014Paris, Francia
E. Lévy
Affiliation:
Universidad Paris IX Dauphine, Paris, Francia
Get access

Resumen

Introducción:

Existen pocos datos para estimar la carga de los episodios maníacos sobre los sistemas sanitarios o las estrategias terapéuticas utilizadas. Este estudio se emprendió para identificar las estrategias de tratamiento escogidas, y para evaluar el coste médico directo del “mundo real” de tratar los episodios maníacos que requieren hospitalización.

Método:

Se revisaron los datos de las historias clínicas durante los tres meses posteriores a la hospitalización por un episodio maníaco en Francia. Se evaluó la utilización de recursos sanitarios, se calcularon los costes directos y se analizaron las estrategias de tratamiento. Se revisó un total de 137 historias clinicas (51,8% mujeres; edad media: 35 años) y se recogieron datos sobre 185 hospitalizaciones.

Resultados:

La duración media de la hospitalización fue de 47 días durante el período de estudio. La estrategia de tratamiento más común durante la hospitalización fue la combinación de un estabilizador del estado de ánimo con un medicamento neuroléptico (64% de los pacientes el día 30). Los anticonvulsives, incluidos el valproato (39%) y la carbamacepina (20%) eran más comunes que el litio (52%). El tratamiento recibido durante la hospitalización se continuó por lo general después del alta, con una tendencia a abandonar los neurolépticos y en el sentido de los estabilizadores del estado de ánimo. Los gastos directos medios en que se incurrió durante el período de estudio de tres meses fueron 22.297 euros, debiéndose un 98,6% de ellos a la hospitalización.

Conclusión:

Estos resultados confirman que los costes de tratar un episodio maníaco son altos y se deben de manera abrumadora al coste de la hospitalización.

Keywords

episodio maníacotrastorno bipolarrevisión de casosrecursos sanitariosestabilizador del estado de ánimotratamiento combinado
Type
Artículo original
Information
European Psychiatry (Ed. Española) , Volume 10 , Issue 1 , February 2003 , pp. 38 - 46
Copyright
Copyright © European Psychiatric Association 2003

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Bibliografía

Angst, J. The course of affective disorders. II. Typology of bipolar manic-depressive illness. Arch Psychiatr Nervenkr 1978,226:65–73.CrossRefGoogle ScholarPubMed
Angst, J. The emerging epidemiology of hypomania and bipolar II disorder. J Affect Disord 1998;50:143–51.CrossRefGoogle ScholarPubMed
Baker, CB, Woods, SW, Sernyak, MJ. Cost-effectiveness of divalproex versus lithium. J Clin Psychiatry 1997;58:363–4.CrossRefGoogle ScholarPubMed
Bank, W. World Development Report 1993. Washington: Oxford University Press; 1993.Google Scholar
Calabrese, JR, Woyshville, MJ. Lithium therapy: limitations and altematives in the treatment of bipolar disorders. Ann Clin Psychiatry 1995;7:103–12.CrossRefGoogle Scholar
Chen, YW, Dilsaver, SC. Lifetime rates of suicide attempts among subjects with bipolar and unipolar disorders relative to subjects with other Axis I disorders. Biol Psychiatry 1996,39:896–9.CrossRefGoogle ScholarPubMed
Cohén, LJ. Pharmacoeconomic issues in the treatment of depression. Formulary 1995;30(Suppl l):S20–25.Google ScholarPubMed
Coryell, W, Scheftner, W, Keller, M, Endicott, J, Maser, J, Hermán, GL. The enduring psychosocial consequences of mania and depression. AmJ Psychiatry 1993; 150:720–7.Google ScholarPubMed
Dardennes, RM, Even, C. Is divalproex a cost-effective alternative in the acute and prophylactic treatment of bipolar I disorder? J Clin Psychiatry 1997;58:495–6.CrossRefGoogle ScholarPubMed
Dardennes, R. Lafuma, A, Watkins, S. Traitement préventif des troubles de l’humeur: comparaison coüt-effficacité du lithium et de la carbamazépine. L’Encéphale 1999,15:391–400.Google Scholar
Das Gupta, R, Guest, JF. Annual cost of bipolar disorder to UK society. Br J Psychiatry 2002; 180:227–33.CrossRefGoogle ScholarPubMed
Dictionnaire Vidal. París: OVP-Editions Vidal; 1999.Google Scholar
Egeland, JA. Bipolarity: the iceberg of affective disorders? Compr Psychiatry 1983;24:337–44.CrossRefGoogle ScholarPubMed
Fenton, FR, Tessier, L, Struening, EL, Smith, FA, Benoit, C, Contandriopoulos, AP, et al.A two-year follow-up of a comparative trial of the cost-eifectiveness of home and hospital psychiatric treatment. Can J Psychiatry 1984;29:205–11.CrossRefGoogle ScholarPubMed
Gershon, S, Soares, JC. Current therapeutic proflle of lithium. Arch Gen Psychiatry 1997,54:16–20.CrossRefGoogle Scholar
Jamison, KR. Suicide and bipolar disorder. J Clin Psychiatry 2000;61:47–51.Google ScholarPubMed
Johnson, RE, McFarland, BH. Lithium use and discontinuation in a health maintenance organization. Am J Psychiatry 1996;153:993–1000.Google Scholar
Keck, PE, Nabulsi, AA, Taylor, JL, et al.A pharmacoeconomic model of divalproex vs. lithium in the acute and the prophylactic treatment of BPD I. J Clin Psychiatry 1996;57:213–22.Google Scholar
Keller, MB, Lavori, PW, Coryell, W, Andreasen, NC, Endicott, J, Clayton, PJ, et al.Differential outcome of puré manic, mixed/ cycling, and puré depressive episodes in patients with bipolar illness. JAMA 1986;255:3138–42.CrossRefGoogle ScholarPubMed
Kessler, RC, McGonagle, KA, Zhao, S, et al.Lifetime and 12- month prevalence of DSM-III-R psychiatric disorders in the United States. Results from the National Comorbidity Survey. Arch Gen Psychiatry 1994;51:8–19.CrossRefGoogle ScholarPubMed
Lapierre, Y, Bentkover, J, Schainbaum, S, Manners, S. Direct cost of depression: analysis of treatment costs of paroxetine versus Imipramine in Cañada. Can J Psychiatry 1995;40:370–7.CrossRefGoogle ScholarPubMed
Le Pen, C, Levy, E, Ravily, V, Beuzen, JN, Meurgey, F. The cost of treatment dropout in depression. A cost-benefit analysis of fluoxetine vs. tricyclics. J Affect Disord 1994;31:1–18.CrossRefGoogle ScholarPubMed
Nomenclature Generale des Actes Professionels et Biologiques. 1999.Google Scholar
Post, RM, Denicoff, KD, Frye, MA, Leverich, GS. Algorithms for bipolar mania. Mod Probl Pharmacopsychiatry 1997;25:114–45.CrossRefGoogle ScholarPubMed
Rouillon, F. Epidemiology of bipolar disorders. Current studies. Encephale 1997;23(Spec No 1):7–11.Google ScholarPubMed
Sachs, G, Printz, D, Kahn, D, Carpenter, D, Docherty, J. The expert consensus guideline series: medication treatment of bipolar disorder. Postgrad Med Special Report 2000;April:l–105.Google ScholarPubMed
Simón, GE, Unutzer, J. Health care utilization and costs among patients treated for bipolar disorder in an insured population. Psychiatr Serv 1999;50:1303–8.CrossRefGoogle Scholar
Simpson, SG, Jamison, KR. The risk of suicide in patients with bipolar disorders. J Clin Psychiatry 1999;60:53–6 Discussion 75-6, 113-6.Google ScholarPubMed
Stender, M, Bryant-Comstock, L, Phillips, S. Utilization of medical services in bipolar I disorder. Eur Neuropsychopharmacol 1998;8(Suppl 2):S298–S298.CrossRefGoogle Scholar
Strakowski, SM, DelBello, MP. The co-occurrence of bipolar and substance use disorders. Clin Psychol Rev 2000;20:191–206.CrossRefGoogle ScholarPubMed
Walden, J, Grunz, H, Schlosser, S, Berger, M, Bergmann, A. Recommendations for the treatment of bipolar affective disorder. Psychopharmakotherapie 1999;6:115–23.Google Scholar
Weissman, MM, Leaf, PJ, Tischler, GL, Blazer, DG, Kamo, MBmce, ML, et al.Affective disorders in flve United States communities. Psychol Med 1988;18:141–53.CrossRefGoogle ScholarPubMed
Wells, KB, Stewart, A, Hays, RD, Bumam, MA, Rogers, W. Daniels, M, et al.see commentsThe functioning and wellbeing of depressed patients. Results from the Medical Outcomes Study. JAMA 1989;262:914–9.CrossRefGoogle Scholar
Winokur, G, Turvey, C, Akiskal, H, Coryell, W, Solomon, D, León, A, et al.Alcoholism and drug abuse in three groupsbipolar I, unipolars and their acquaintances. J Affect Disord 1998;50:81–9.CrossRefGoogle ScholarPubMed
World Health Organisation. ICD-10 International Statistical Classificatíon of Diseases and Related Health Problems. Geneva, Switzerland: WHO; 1994.Google Scholar
Wyatt, RJ, Henter, I. An economic evaluation of manicdepressive illness. Soc Psychiatry Psychiatr Epidemiol 1995; 30:213–9.Google Scholar