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dc.contributor.authorKaranti, Alina Aikaterini
dc.date.accessioned2020-02-18T07:29:15Z
dc.date.available2020-02-18T07:29:15Z
dc.date.issued2020-02-18
dc.identifier.isbn978-91-7833-730-9 (PRINT)
dc.identifier.isbn978-91-7833-731-6 (PDF)
dc.identifier.urihttp://hdl.handle.net/2077/62687
dc.description.abstractThis thesis comprises five studies based on prospective, longitudinal data from the Swedish national quality register BipoläR. Study I examined the differences between bipolar subtype I and II with respect to clinical features, course of illness, comorbidity, and socioeconomic factors. Study II investigated temporal changes in drug prescription patterns in bipolar disorder. Study III examined the effectiveness of psychoeducation for bipolar disorder. Study IV and V examined health inequalities in the management of bipolar disorder with respect to sex and patients’ educational level, respectively. Results showed noticeable phenomenological differences between the BDI and BDII, where BDII has a different and more complex clinical presentation in terms of illness course and comorbidity (Study I). This supports the validity of separating BDI and BDII. Concerning pharmacological treatment, we found that lithium use decreased during the study period, while lamotrigine and quetiapine increased. The use of antidepressants remained unchanged in BDII but increased somewhat in BDI (Study II). We found that psychoeducation decreased the risk for depressive and manic episodes as well as inpatient care in routine clinical practice (Study III). Lastly, we found differences in the management of bipolar disorder without apparent medical rationale. Whereas women were more likely to receive psychotherapy, antidepressants, benzodiazepines, antipsychotics, lamotrigine, and electroconvulsive therapy, men were more likely to use lithium (Study IV). Further, higher education in patients increased the likelihood of receiving psychotherapy and psychoeducation, but decreased likelihood of receiving first-generation antipsychotics, tricyclic antidepressants, and compulsory inpatient care (Study V).sv
dc.language.isoengsv
dc.relation.haspartI) Karanti, A., Kardell, M., Joas, E., Runeson, B., Pålsson, E., Landén, M. Characteristics of bipolar I and II disorder: a study of 8,766 individuals. Bipolar Disorders. 2019 November 14. ::doi::10.1111/bdi.12867sv
dc.relation.haspartII) Karanti, A., Kardell, M., Lundberg, U., Landén, M. Changes in mood stabilizer prescription patterns. Journal of Affective Disorders, 2016 May; 195: 50-6. ::doi::10.1016/j.jad.2016.01.043sv
dc.relation.haspartIII) Joas, E., Bäckman, K., Karanti, A., Sparding, T., Colom, F., Pålsson, E., Landén, M. Psychoeducation for bipolar disorder and risk of recurrence and hospitalization – a within-individual analysis using registry data. Psychological Medicine, 2019 May 6:1-7. ::doi::10.1017/S0033291719001053sv
dc.relation.haspartIV) Karanti, A., Bobeck, C., Osterman, M., Kardell, M., Tidemalm, D., Runeson, B., Lichtenstein, P., Landén, M. Gender differences in the treatment of patients with bipolar disorder: a study of 7354 patients. Journal of Affective Disorders, 2015 Mar 15; 174: 303-9. ::doi::10.1016/j.jad.2014.11.058sv
dc.relation.haspartV) Karanti, A., Bublik, L., Kardell, M., Annerbrink, K., Runeson, B., Lichtenstein, P., Pålsson, E., Landén, M. Patients’ educational level and management of bipolar disorder. Submittedsv
dc.subjectbipolar disorderssv
dc.subjectdrug therapysv
dc.subjectlithiumsv
dc.subjectlamotriginesv
dc.subjectquetiapinesv
dc.subjectmood stabilizerssv
dc.subjectantidepressantssv
dc.subjectelectroconvulsive therapysv
dc.subjectpsychotherapysv
dc.subjectpsychoeducationsv
dc.subjectcomorbiditysv
dc.subjectsocioeconomic factorssv
dc.subjecthealthcare disparitysv
dc.subjectgendersv
dc.subjecteducationsv
dc.titleBipolar disorders: Subtypes, treatments, and health inequalitiessv
dc.typetexteng
dc.type.svepDoctoral thesiseng
dc.gup.mailalina.karanti@vgregion.sesv
dc.type.degreeDoctor of Philosophy (Medicine)sv
dc.gup.originUniversity of Gothenburg. Sahlgrenska Academysv
dc.gup.departmentInstitute of Neuroscience and Physiology. Department of Psychiatry and Neurochemistrysv
dc.gup.defenceplaceFredagen den 13 mars 2020, kl 13.00, Hörsal Arvid Calrsson, Academicum, Medicinaregatan 3, Göteborgsv
dc.gup.defencedate2020-03-13
dc.gup.dissdb-fakultetSA


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