transtorno afetivo bipolar: carga da doença e custos relacionados bipolar disorder: burden of disease and related costs

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ID: 148489
2008
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Abstract
CONTEXTO: O transtorno afetivo bipolar (TAB) é uma doença recorrente, crônica e grave. Comorbidades psiquiátricas e físicas, aumento do risco de suicídio, maior utilização de serviços de saúde e prejuízo na esfera social/profissional aumentam significativamente a carga e custos relacionados à doença. OBJETIVOS: Revisar aspectos clínicos, de carga da doença e conseqüentes desfechos financeiros do TAB. MÉTODOS: Pesquisa de base de dados MEDLINE/PubMed utilizando os termos bipolar disorder, epidemiology, burden of disease, comorbidity, cost of illness, outcomes e financial consequences, publicados entre 1980 e 2006. RESULTADOS: O TAB apresenta alta comorbidade com outros transtornos, o que agrava seu prognóstico e eleva os custos com os serviços de saúde. Os indivíduos com TAB apresentam mais fatores de risco cardiovascular e, conseqüentemente, maior risco de morte por evento cardíaco. O atraso e o erro diagnóstico no TAB elevam consideravelmente a carga e os custos da doença. CONCLUSÕES: As comorbidades, o risco de suicídio, o prejuízo social/profissional e a baixa adesão ao tratamento contribuem para a alta carga e os custos associados à doença. A pesquisa de comorbidades pode ajudar os médicos a ajustarem suas estratégias de tratamento, considerando cuidadosamente todos os fatores de risco e custos associados, fatores estes que devem ser levados em conta também pelos profissionais que trabalham com gestão de saúde, tanto no setor privado quanto público.
BACKGROUND: Bipolar disorder (BD) is a recurrent, chronic and severe disease. Mental and physical comorbidities, risk of suicide, health services use and impairment of social and professional domains significantly worsen the burden and increase the costs of illness. OBJECTIVES: Review clinical aspects, burden of disease, and consequent financial outcomes of BD. METHODS: MEDLINE/PubMed database search using the terms bipolar disorder, epidemiology, burden of disease, comorbidity, cost of illness, outcomes e financial consequences, published in MEDLINE from 1980 to 2006. RESULTS: BD has a high rate of comorbidities, which worsen the prognosis and increase costs with health services. Subjects with BD have more cardiovascular risk factors than the general population, and therefore a higher risk of death by cardiovascular event. Delay of diagnosis and misdiagnosis increase the costs of illness. DISCUSSION: Comorbidities, risk of suicide, social and professional impairment and low adherence to treatment increase the cost of illness. The search of comorbidities may help clinicians to adjust treatment strategies, taking into account all associated risk factors and costs, which may be considered also by professionals involved in health care management, either private or public.
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costa2008archivestranstorno Use this key to autocite in the manuscript while using SciMatic Manuscript Manager or Thesis Manager
Authors Anna Maria Niccolai Costa
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Journal arthritis research & therapy
Year 2008
DOI
10.1590/S0101-60832008000300003
URL
http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0101-60832008000300003
Keywords
bipolar disorder psychiatry comorbidity psiquiatría cost of illness

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