Real-World treatment patterns in inpatients with newly diagnosed bipolar disorder in China: A descriptive longitudinal study.

BACKGROUND

Bipolar disorder imposes a substantial global health burden. While international clinical guidelines exist, real-world treatment patterns for bipolar disorder in China remains poorly characterized. This study aimed to characterize initial treatment selection, pharmacologic class distribution, and longitudinal prescription adjustments among inpatients with newly diagnosed bipolar disorder in Beijing, China, from 2010 to 2017.

METHODS

A population-based longitudinal study was conducted utilizing data from the Beijing Medical Claim Data for Employees. We included 3034 inpatients newly diagnosed with bipolar disorder using ICD-10 code. We analyzed initial treatment patterns, annual prescription trends, and treatment modifications from the acute phase to maintenance phase.

RESULTS

Over half (57.3%) of patients started on polypharmacy. Quetiapine was the most prescribed antipsychotic (43.8%), and lithium the most common mood stabilizer (37.7%). Alarmingly, the rate of treatment discontinuation reached 42.7% by the end of the first year after initiating treatment. Prescribing trends showed increasing use of aripiprazole and valproate over time. The high rate of antidepressant use (44.2% during follow-up) and significant treatment discontinuation highlight the complexity of real-world clinical management compared with international guideline recommendations.

CONCLUSIONS

These findings highlight a gap between real-world practices and guideline recommendations, underscoring need for initiatives to promote evidence-based, continuous care for bipolar disorder management in China.