Pharmacotherapy, Psychotherapeutic and Psychosocial Treatments Work Together Toward Recovery: a Study On Mixed Features Bipolar Disorder.

Abstract

Introduction

Pharmacological treatment have a key role in themanagement of Severe Mental Illness, reducing hospitalization and acute episodes, supporting and enhancing psychotherapy and recovery process. In aninstitutional pathway to remission and recovery it’s much better if thecharacteristics of chosen drugs worktogether with other kind of interventions. DSM-5 includes a new specifier 'withmixed features” for mood episodes, considering by clinicians difficult-to-treatand associated with a poorer prognosis.

Objectives

We evaluated, in patients admitted to our day-hospitalpsychodinamically-oriented treatment program, the impact of mixed featurestreatment on compliance and on clinicaloutcome.

Methods

We have included a small sample of patients withbipolar disorder based on DSM V, aged between 18 and 65. Patients are assessedby BPRS and M.I.N.I. in to analyze theimpact of different antipsychotics on specific symptomatology cluster, focusingon mixed features, and CGI and VGF toevaluate working and social functioning. Changes from baseline to 12-weeks intotal score and in partial score for symptomatology clusters was considered.

Results

Asenapine improved mixed features (ANOVA, p<0,05). Moreover is associated with a lower rate of metabolic syndrome compared toother antipsychotics. The improvement of mixed symptoms and the decrease ofmetabolic syndrome incidence enhance treatment adherence.

Conclusions

Our treatment model, where converge psychiatrics, psychologists, physicians andrehabilitation operators, allows a drugchoice focused on symptoms assisting psychotherapeutic play and an early noticeof side effects, advancing towards recovery. Asenapine, in the treatment ofmixed features, enhances the efficacy of the program in bipolar patients.