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Burden on caregivers of older patients with bipolar disorder
- Authors:
- DOLS Annemiek, et al
- Journal article citation:
- Aging and Mental Health, 22(5), 2018, pp.686-691.
- Publisher:
- Taylor and Francis
Objectives: Available data suggest high burden on caregivers of patients with bipolar disorder (BD), yet the well-being of patients with BD increasingly depends on family members, partners and close friends. As patients with BD get older, the need for informal care may shift. We aimed to describe the caregivers of older adults with BD (OABD) and explore what patients' and caregivers' characteristics are associated with caregiver burden. Method: Forty-seven caregivers of OABD were questioned about their perceived burden and depressive symptoms. Linear regression analyses were performed to examine the influence of various patients' and caregivers' characteristics on caregiver burden or depression. Results: More than half of all caregivers experienced some degree of burden,and 6.4% reported depressive symptoms. The number of psychiatric admissions and social functioning were the only patients' characteristics associated with higher burden. Caregiver burden was significantly associated with caregiver's other obligations. None of the patient or caregiver characteristics was significantly associated with depression in caregivers of OABD. Conclusion: In OABD, even with few residual symptoms, more than half of all caregivers experience substantial burden. Future studies are needed to confirm if improving social functioning and preventing psychiatric hospitalizations decrease the burden on the caregivers of OABD. (Edited publisher abstract)
Working alliance in patients with severe mental illness who need a crisis intervention plan
- Authors:
- RUCHLEWSKA Asia, et al
- Journal article citation:
- Community Mental Health Journal, 52(1), 2016, pp.102-108.
- Publisher:
- Springer
Working alliance has been characterised as an important predictor of positive treatment outcomes. This study examined whether illness insight, psychosocial functioning, social support and locus of control were associated with working alliance as perceived by both patient and clinician. A total of 195 outpatients with psychotic or bipolar disorders were assessed. Findings indicated that patients rated the alliance more positively when they experienced a greater need for treatment, fewer behavioural and social problems, and more psychiatric symptoms. Clinicians rated the alliance more positively in patients who reported fewer social problems and better illness insight. Patients’ demographic characteristics, including being female and married, were also positively related to the clinician-rated alliance. The results suggest that patients and clinicians have divergent perceptions of the alliance. Clinicians may need help developing awareness of the goals and tasks of patients with certain characteristics, i.e., singles, men, those with poor illness insight and those who report poor social functioning. (Edited publisher abstract)
The care needs of older patients with bipolar disorder
- Authors:
- DAUTZENBERG Geraud, et al
- Journal article citation:
- Aging and Mental Health, 20(9), 2016, pp.899-907.
- Publisher:
- Taylor and Francis
Objectives: With ageing, bipolar disorder evolves into a more complex illness, with increasing cognitive impairment, somatic comorbidity, and polypharmacy. To tailor treatment of these patients, it is important to study their needs, as having more unmet needs is a strong predictor of a lower quality of life. Method: Seventy-eight Dutch patients with bipolar I or II disorder aged 60 years and older in contact with mental health services were interviewed using the Camberwell Assessment of Need in the Elderly (CANE) to assess met and unmet needs, both from a patient and a staff perspective. Results: Patients (mean age 68 years, range 61–98) reported a mean of 4.3 needs compared to 4.4 reported by staff, of which 0.8 were unmet according to patients and 0.5 according to staff. Patients frequently rated company and daytime activities as unmet needs. More current mood symptoms were associated with a higher total number of needs. Less social participation was associated with a higher total number of needs and more unmet needs. Conclusion: Older bipolar patients report fewer needs and unmet needs compared to older patients with depression, schizophrenia, and dementia. A plausible explanation is that older bipolar patients had higher Global Assessment of Functioning scores, were better socially integrated, and had fewer actual mood symptoms, all of which correlated with the number of needs in this study. The results emphasise the necessity to assess the needs of bipolar patients with special attention to social functioning, as it is suggested that staff fail to recognise or anticipate these needs. (Edited publisher abstract)