Hostname: page-component-78c5997874-8bhkd Total loading time: 0 Render date: 2024-11-20T03:29:29.979Z Has data issue: false hasContentIssue false
  • English
  • Français

Manic episodes: the direct cost of a three-month period following hospitalisation

Published online by Cambridge University Press:  16 April 2020

J.P. Olié  and
E. Lévy
J.P. Olié*
Affiliation:
Centre hospitalier Sainte-Anne, 1, rue Cabanis, 75014Paris, France
E. Lévy
Affiliation:
Université Paris IX Dauphine, Paris, France
*
*Corresponding author.
Get access

Summary

Introduction.

Few data exist to estimate the burden of manic episodes on healthcare systems or the therapeutic strategies used. This study was undertaken to identify treatment strategies chosen, and to assess the “real-world” direct medical cost of treating manic episodes necessitating hospitalisation.

Method.

Case record data were reviewed during the three months following hospitalisation for a manic episode in France. Healthcare resource utilisation was assessed, direct costs calculated, and treatment strategies analysed. A total of 137 patients files (51.8% female; mean age: 35 years) were reviewed and data on 185 hospitalisations collected.

Results.

The mean duration of hospitalisation was 47 days over the study period. The most common treatment strategy during hospitalisation was the combination of a mood stabiliser with a neuroleptic drug (64% of patients at day 30). Anticonvulsants including valproate (39%) and carbamazepine (20%) were more common than lithium (42%). Treatment received during hospitalisation was generally continued after discharge, with a trend away from neuroleptics and towards mood stabilisers. The mean direct costs incurred over the three-month study period was Euro 22 297, with 98.6% of those costs due to hospitalisation.

Conclusion.

These results confirm that the costs of treating a manic episode are high, and overwhelmingly due to the cost of hospitalisation.

Keywords

Manic episodeBipolar disorderCase reviewHealth care resourcesMood-stabiliserCombination treatment
Type
Original article
Information
European Psychiatry , Volume 17 , Issue 5 , September 2002 , pp. 278 - 286
Copyright
Copyright © European Psychiatric Association 2002

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

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, CBWoods, SWSernyak, MJ. Cost-effectiveness of dival-proex versus lithium. J Clin Psychiatry 1997;58:363–4.CrossRefGoogle Scholar
Bank, W. World Development Report 1993. Washington: Oxford University Press; 1993.CrossRefGoogle Scholar
Calabrese, JRWoyshville, MJ. Lithium therapy: limitations and alternatives in the treatment of bipolar disorders. Ann Clin Psychiatry 1995;7:103–12.CrossRefGoogle ScholarPubMed
Chen, YWDilsaver, 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
Cohen, LJ. Pharmacoeconomic issues in the treatment of depres-sion. Formulary 1995;30(Suppl 1):S20–25.Google Scholar
Coryell, WScheftner, WKeller, MEndicott, JMaser, JKlerman, GL. The enduring psychosocial consequences of mania and depression. Am J Psychiatry 1993;150:720–7.Google ScholarPubMed
Dardennes, RMEven, 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, RLafuma, AWatkins, S. Traitement préventif des troubles de l’humeur: comparaison coût-efficacité du lithium et de la carbamazépine. L’Encéphale 1999;15:391–400.Google Scholar
Das Gupta, RGuest, JF. Annual cost of bipolar disorder to UK society. Br J Psychiatry 2002;180:227–33.CrossRefGoogle ScholarPubMed
Dictionnaire Vidal. Paris: OVP-Editions Vidal; 1999.Google Scholar
Egeland, JA. Bipolarity: the iceberg of affective disorders? Compr Psychiatry 1983;24:337–44.CrossRefGoogle ScholarPubMed
Fenton, FRTessier, LStruening, ELSmith, FABenoit, CContandriopoulos, AP et al. A two-year follow-up of a comparative trial of the cost-effectiveness of home and hospital psychiatric treatment. Can J Psychiatry 1984;29:205–11.CrossRefGoogle ScholarPubMed
Gershon, SSoares, JC. Current therapeutic profile of lithium. Arch Gen Psychiatry 1997;54:16–20.CrossRefGoogle ScholarPubMed
Jamison, KR. Suicide and bipolar disorder. J Clin Psychiatry 2000;61:47–51.Google ScholarPubMed
Johnson, REMcFarland, BH. Lithium use and discontinuation in a health maintenance organization. Am J Psychiatry 1996; 153:993–1000.Google Scholar
Keck, PENabulsi, AATaylor, 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, MBLavori, PWCoryell, WAndreasen, NCEndicott, JClayton, PJ et al. Differential outcome of pure manic, mixed/ cycling, and pure depressive episodes in patients with bipolar illness. JAMA 1986;255:3138–42.Google ScholarPubMed
Kessler, RCMcGonagle, KAZhao, 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, YBentkover, JSchainbaum, SManners, S. Direct cost of depression: analysis of treatment costs of paroxetine versus Imipramine in Canada. Can J Psychiatry 1995;40:370–7.CrossRefGoogle ScholarPubMed
Le Pen, CLevy, ERavily, VBeuzen, JNMeurgey, 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 Générale des Actes Professionels et Biologiques. 1999.Google Scholar
Post, RMDenicoff, KDFrye, MALeverich, 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, GPrintz, DKahn, DCarpenter, DDocherty, J. The expert consensus guideline series: medication treatment of bipolar disorder. Postgrad Med Special Report 2000;April:1–105.Google Scholar
Simon, GEUnutzer, J. Health care utilization and costs among patients treated for bipolar disorder in an insured population. Psychiatr Serv 1999;50:1303–8.Google Scholar
Simpson, SGJamison, 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, MBryant-Comstock, LPhillips, S. Utilization of medical services in bipolar I disorder. Eur Neuropsychopharmacol 1998;8(Suppl 2):S298–S298.CrossRefGoogle Scholar
Strakowski, SMDelBello, MP. The co-occurrence of bipolar and substance use disorders. Clin Psychol Rev 2000;20:191–206.CrossRefGoogle ScholarPubMed
Walden, JGrunz, HSchlosser, SBerger, MBergmann, A. Recommendations for the treatment of bipolar affective disorder. Psychopharmakotherapie 1999;6:115–23.Google Scholar
Weissman, MMLeaf, PJTischler, GLBlazer, DGKarno, MBruce, ML et al. Affective disorders in five United States communities. Psychol Med 1988;18:141–53.Google ScholarPubMed
Wells, KBStewart, AHays, RDBurnam, MARogers, WDaniels, M et al. see commentsThe functioning and well-being of depressed patients. Results from the Medical Outcomes Study. JAMA 1989;262:914–9.Google Scholar
Winokur, GTurvey, CAkiskal, HCoryell, WSolomon, DLeon, A et al. Alcoholism and drug abuse in three groups-bipolar I, unipolars and their acquaintances. J Affect Disord 1998;50:81–9.CrossRefGoogle ScholarPubMed
World Health Organisation. ICD-10 International Statistical Classification of Diseases and Related Health Problems. Geneva, Switzerland: WHO; 1994.Google Scholar
Wyatt, RJHenter, I. An economic evaluation of manic-depressive illness. Soc Psychiatry Psychiatr Epidemiol 1995;30:213–9.Google ScholarPubMed
Submit a response

Comments

No Comments have been published for this article.