One-Year Treatment Outcomes of African-American and Hispanic Patients With Bipolar I or II Disorder in STEP-BD
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Author
Gonzalez, Jodi
Bowden, Charles
Berman, Nancy
Frank, Ellen
Kogan, Jane
Miklowitz, David
Note: Order does not necessarily reflect citation order of authors.
Published Version
https://doi.org/10.1176/appi.ps.61.2.164Metadata
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Gonzalez, Jodi, Charles Bowden, Nancy Berman, Ellen Frank, Mark Bauer, Jane Kogan, Margarita Alegría, and David Miklowitz. 2010. “One-Year Treatment Outcomes of African-American and Hispanic Patients With Bipolar I or II Disorder in STEP-BD.” Psychiatric Services 61 (2) (February 1). doi:10.1176/appi.ps.61.2.164.Abstract
ObjectiveFew studies have compared treatment outcomes of African-American, Hispanic, and non-Hispanic white patients with bipolar disorder. The U.S. Systematic Treatment Enhancement Program for Bipolar Disorder compared one-year outcomes for bipolar I or II disorder from each of these racial-ethnic groups.
Methods
African Americans (N=155) were retrospectively compared with a matched group of non-Hispanic whites (N=729), and Hispanics (N=152) were compared with a separate matched group of non-Hispanic whites (N=822). Response and recovery outcomes were examined. Survival analysis was used to compare time to treatment response for depression (Montgomery-Asberg Depression Rating Scale) and mania (Young Mania Rating Scale) as well as global assessment of functioning (Global Assessment of Functioning).
Results
For manic and depressive symptoms, time to response and proportion of responders were similar across groups. Over the study year the proportion of days well was similar across groups. A smaller proportion of African Americans met criteria for improved global functioning. Depression response among African Americans with psychotic symptoms was slower than the response among African Americans without psychotic symptoms and among non-Hispanic whites with or without psychotic symptoms. No differences between Hispanics and non-Hispanic whites in response times and recovery were observed.
Conclusions
Results are consistent with U.S. clinical trials for other psychiatric disorders, which have reported similar outcomes for ratings of primary symptoms. Baseline psychotic symptoms are likely a significant contributor when African Americans with bipolar disorder are slow to recover. These results may be less generalizable to uninsured patients.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3390227/Terms of Use
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