Search results for ‘Subject term:"bipolar disorder"’ Sort:
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Effects of anxiety on the long-term course of depressive disorders
- Authors:
- CORYLL William, et al
- Journal article citation:
- British Journal of Psychiatry, 200(3), March 2012, pp.210-215.
- Publisher:
- Cambridge University Press
Longitudinal studies of depressive disorders have associated comorbid anxiety with poorer outcomes in terms of treatment response, recovery time and depressive morbidity. This US study examined the relative prognostic importance of specific anxiety features in order to determine whether their effects persist over decades and apply to both unipolar and bipolar conditions. Participants with unipolar (n = 476, mean age at intake 39.5 years, 59.6% female) or bipolar (n = 335, mean age at intake 36.3 years, 60.7% female) depressive disorders were intensively followed for a mean of 16.7 years. The number and severity of anxiety symptoms, but not the presence of pre-existing anxiety disorders, showed a robust and continuous relationship to the subsequent time spent in depressive episodes in both unipolar and bipolar depressive disorder. The strength of this relationship changed little over the study period. The authors conclude that the severity of current anxiety symptoms within depressive episodes correlates strongly with the persistence of subsequent depressive symptoms and this relationship is stable over decades.
Effects of severe mental illness on survival of people with diabetes
- Authors:
- VINOGRADOVA Yana, et al
- Journal article citation:
- British Journal of Psychiatry, 197(4), October 2010, pp.272-277.
- Publisher:
- Cambridge University Press
This study tested the hypothesis that having a mental health problem increases the risk of premature death in individuals with diabetes in the same way that it does for the general population. A total of 43,992 people with diabetes were drawn from the QRESEARCH database population of over 9 million patients in the UK. Survival rates during the five-year study period, and hazard ratios for deaths associated with schizophrenia and bipolar disorder, were adjusted by age and gender and additionally for socioeconomic status, obesity, smoking and use of statins. A total of 257 people diagnosed with schizophrenia, 159 with bipolar disorder and 14 with both conditions were identified from the database population. Crude survival rates revealed no significant differences between the groups. However people with schizophrenia or bipolar disorder and diabetes, compared with those with diabetes alone, had a significantly increased risk of death after adjusting for age and gender; hazard ratio for schizophrenia 1.84 and for bipolar disorder 1.51. After adjusting for the other factors, hazard ratios were 1.52 for schizophrenia and 1.47 for bipolar disorder. It is concluded that people with schizophrenia or bipolar disorder in addition to diabetes have a relatively higher mortality rate. Possible explanations include: diabetes progressing more rapidly or being more poorly controlled; and higher levels of comorbidity resulting in death from other causes.
Psychiatric comorbidity in older adults with bipolar disorder
- Authors:
- SAJATOVIC Martha, BLOW Frederick C., IGNACIO Rosalinda V.
- Journal article citation:
- International Journal of Geriatric Psychiatry, 21(6), June 2006, pp.582-587.
- Publisher:
- Wiley
Comorbidity patterns and correlates among older adults with bipolar disorder (BPD) are not well understood. The aim of this analysis was to examine the prevalence of comorbid PTSD and other anxiety disorders, substance abuse and dementia in a population of 16,330 geriatric patients with BPD in a Veterans Health Administration administrative database. Patients were identified from case registry files during Federal Fiscal Year 2001(FY01). Comorbidity groups were compared on selected clinical characteristics, inpatient and outpatient health resource use, and costs of care. Four thousand six hundred and sixty-eight geriatric veterans with BPD were comorbid for either substance abuse, PTSD and other anxiety disorder, or dementia (28.6% of all veterans with BPD age 60 or older). Mean age of all veterans in the four comorbidity groups was 70.0 years (±SD 7.2 years). Substance abuse was seen in 1,460 (8.9%) of elderly veterans with BPD, while PTSD was seen in 875 (5.4%), other anxiety disorders in 1592 (9.7%), and dementia in 741 (4.5%) of elderly veterans. Individuals with substance abuse in this elderly bipolar population are more likely to be younger, minority, unmarried and homeless compared to elderly bipolar populations with anxiety disorders or dementia. Inpatient use was greatest among geriatric veterans with BPD and dementia compared to veterans with BPD and other comorbid conditions. Clinical characteristics, health resource use and healthcare costs differ among geriatric patients with BPD and comorbid anxiety, substance abuse or dementia. Additional research is needed to better understand presentation of illness and modifiable factors that may influence outcomes.
Co-morbid bipolar and alcohol use disorders: a treatment-focused review
- Authors:
- PRISCIANDAROA James J., MYRICK D. Hugh
- Journal article citation:
- Journal of Dual Diagnosis, 6(2), April 2010, pp.171-188.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
Treatment of bipolar disorders or alcohol misuse is quite difficult. However, these are commonly combined, making diagnosis and treatment increasingly complex, and are often associated with poor outcomes. This article concisely reviews the diagnosis, epidemiology, consequences, and neurobiological similarities of these two conditions among individuals with dual diagnoses, and reviews the pharmacological and psychosocial treatment of bipolar and alcohol use disorders both alone and in combination. The article highlights how dual diagnosis is often complicated by the fact that intoxication and withdrawal states can mimic psychiatric illness, and, furthermore, the neuroadaptive changes associated with the chronic use of alcohol may cause alterations in neurotransmission, thereby inducing a psychiatric illness. In closing, evidence for the effectiveness of treatments for individuals with dual diagnoses (i.e., divalproex, atypical antipsychotics, naltrexone, cognitive-behavioural therapy, and integrated group therapy) is discussed, and areas for future treatment development and evaluation are identified.
Mental health and wellbeing in England: Adult Psychiatric Morbidity Survey 2014
- Authors:
- McMANUS S., et al
- Publisher:
- NHS Digital
- Publication year:
- 2016
- Pagination:
- 405
- Place of publication:
- Leeds
The fourth survey of the mental health of adults living in private households in England, which are carried out every seven years using a large representative sample of 7,500 people, including those who do not access services. The report presents estimates on prevalence and trends in mental health conditions and contains information on age, sex, ethnicity, employment and benefit status, region, household composition, and the level and nature of mental health treatment and service use. Chapters cover common mental health disorders, mental health treatment and service users, post-traumatic stress disorder, psychotic disorder, autistic spectrum disorder, personality disorder, attention-deficit/hyperactivity disorder, bipolar disorder, alcohol dependence, drug use and dependence, suicide attempts and self-harm, and comorbidity in mental and physical illness. Trends identified include: an increase in the numbers of women with common mental health disorders, with numbers in men remaining largely stable; young women emerging as a high-risk group, with high rates of common mental health disorders and self-harm. Most mental disorders were also more common in people living alone, people with poor physical health, and the unemployed. (Edited publisher abstract)
Dual diagnosis variations across differing comorbid diagnoses
- Authors:
- BREMS Christiane, et al
- Journal article citation:
- Journal of Dual Diagnosis, 2(3), 2006, pp.109-129.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
This article explores whether the type of psychiatric disorder coexisting with a substance use disorder makes a difference in terms of the sequellae of the disorders for the patient. The study explored a variety of psychosocial/demographic and clinical variables for patients with a substance abuse disorder, differentiating five groups based on the type of coexisting psychiatric disorder: schizophrenia, depression, bipolar disorder, adjustment disorder, and personality disorder. Rates and sequellae of comorbidity for the five groups of patients were explored based on a pool of patients hospitalized at the Alaska Psychiatric Institute (API) between 1993 and 2001. The records of 181 patients with coexisting schizophrenia, 251 with depression, 120 with bipolar disorder, 197 with adjustment disorder, and 145 with personality disorder were utilized to explore psychosocial/demographic and clinical differences and commonalities across groups. Findings revealed significant differences between the five groups on almost all psychosocial/demographic and clinical variables. For example, patients with coexisting schizophrenia evidence more severe pathology and greater use of hospital resources; patients with coexisting personality disorder were more likely to be involved with the legal system; patients with bipolar disorder were most likely to evidence drug involvement at admission; and patients with adjustment disorders evidenced the fewest psychosocial challenges and a less severe course of treatment. Results confirmed the need to differentiate comorbid patients based on the type of coexisting other psychiatric disorder. Discussion of the implications of these findings for treatment service planning on an individual patient and systemic-administrative level is presented. (Copies of this article are available from: Haworth Document Delivery Centre, Haworth Press Inc., 10 Alice Street, Binghamton, NY 13904-1580).
MIDAS: a new service for the mentally ill with comorbid drug and alcohol misuse
- Authors:
- BAYNEY R., ST. JOHN-SMITH P., CONHYE A.
- Journal article citation:
- Psychiatric Bulletin, 26(7), July 2002, pp.251-254.
- Publisher:
- Royal College of Psychiatrists
Describe the work and patient characteristics of one of the first combined mental illness and drug and alcohol services (MIDAS) in the UK. Examines MIDAS as an assertive community service, for individuals receiving long-term community care. Results found patients with bipolar affective disorder and personality disorders were more likely to use the service than patients with unipolar disorder or schizophrenia. Despite the use of an assertive service, there was difficulty engaging patients with schizophrenia and comorbid drug use.