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Prospective 12-month course of bipolar disorder in out-patients with and without comorbid anxiety disorders
- Authors:
- OTTO M. W., et al
- Journal article citation:
- British Journal of Psychiatry, 189(1), July 2006, pp.20-25.
- Publisher:
- Cambridge University Press
The impact of anxiety disorders has not been well delineated in prospective studies of bipolar disorder. The aim was to examine the association between anxiety and course of bipolar disorder, as defined by mood episodes, quality of life and role functioning. A thousand out-patients with bipolar disorder were followed prospectively for 1 year. A current comorbid anxiety disorder (present in 31.9% of participants) was associated with fewer days well, a lower likelihood of timely recovery from depression, risk of earlier relapse, lower quality of life and diminished role function over I year of prospective study. The negative impact was greater with multiple anxiety disorders. Anxiety disorders, including those present during relative euthymia, predicted a poorer bipolar course. The detrimental effects of anxiety were not simply a feature of mood state. Treatment studies targeting anxiety disorders will help to clarify the nature of the impact of anxiety on bipolar course.
The double burden of age and disease on cognition and quality of life in bipolar disorder
- Authors:
- WEISENBACK Sara L., et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 29(9), 2014, pp.952-961.
- Publisher:
- Wiley
Objective: Bipolar disorder (BPD) and normal aging are known to impact cognitive skills and health-related quality of life (HRQOL). This study investigated how ageing and disease interact in predicting cognitive and psychosocial outcomes. Methods: Eight cognitive and ten subjective HRQOL domain ratings were measured. Subjects included 80 young (18–29 years) and late middle-aged (50–65 years) BPD patients in the euthymic phase and 70 age-equivalent healthy comparison participants. Results: An age X disease interaction was detected in three domains of cognitive functioning that reflect emotion processing, processing speed, and executive functioning skills, with BPD patients in the older group performing most poorly. There was a double burden of ageing and disease on reported ability to perform physical tasks. However, regardless of age, disease status was associated with lower ratings of HRQOL in the psychosocial/affective sphere and the majority of cognitive domains. Post hoc analyses revealed that number of years ill was positively associated with select HRQOL ratings in older, but not younger BPD adults. Conclusions: These findings may stimulate future longitudinal study of cognition and quality of life in BPD patients across the life span, focusing on additive and interactive effects of aging and disease burden, which could culminate in developing more effective treatment and rehabilitation strategies for this traditionally challenging to treat population. (Publisher abstract)
Quality of life of people with schizophrenia, bipolar disorder and other psychotic disorders
- Authors:
- SAARNI Samuli I., et al
- Journal article citation:
- British Journal of Psychiatry, 197(5), November 2010, pp.386-394.
- Publisher:
- Cambridge University Press
Quality of life (QoL) is an increasingly important outcome measure in healthcare and health economics. This study compared the loss of subjective QoL and utility-based health-related quality of life (HRQoL) associated with psychotic disorders. A population sample of 8,028 Finns, aged 30 and above, was screened for psychotic disorders and bipolar disorder. Lifetime psychotic disorders were diagnosed using the Structured Clinical Interview for DSM–IV and/or case records. Health-related quality of life was tested, and QoL was measured with a 10-point scale. Findings indicated that schizoaffective disorder was associated with the largest losses of QoL and HRQoL, with bipolar I disorder associated with similar or smaller losses. However, current depressive symptoms explained most of the losses. In conclusion, depressive symptoms were the strongest predictors of poor QoL/HRQoL in psychotic disorders. Subjective loss of QoL associated with psychotic disorders was smaller than objective loss of functioning suggests.
Influence of sub-syndromal symptoms after remission from manic or mixed episodes
- Authors:
- TOHEN Mauricio, et al
- Journal article citation:
- British Journal of Psychiatry, 189(6), December 2006, pp.515-519.
- Publisher:
- Cambridge University Press
Sub-syndromal symptoms in bipolar disorder impair functioning and diminish quality of life. The aim was to examine factors associated with time spent with sub-syndromal symptoms and to characterise how these symptoms influence outcomes. In a double-blind randomised maintenance trial, patients received either olanzapine or lithium monotherapy for 1 year. Stepwise logistic regression models were used to identify factors that were significant predictors of percentage time spent with sub-syndromal symptoms. The presence of sub-syndromal symptoms during the first 8 weeks was examined as a predictor of subsequent relapse. Presence of sub-syndromal depressive symptoms during the first 8 weeks significantly increased the likelihood of depressive relapse. Patients with psychotic features and those with a greater number of previous depressive episodes were more likely to experience sub-syndromal depressive symptoms. These findings help to identify patients at increased risk of affective relapse and suggest that appropriate therapeutic interventions should be considered even when syndromal-level symptoms are absent.
The process of recovery from bipolar I disorder: a qualitative analysis of personal accounts in relation to an integrative cognitive model
- Authors:
- MANSELL Warren, et al
- Journal article citation:
- British Journal of Clinical Psychology, 49(2), June 2010, pp.193-215.
- Publisher:
- Wiley
Bipolar I disorder is defined by a history of mania and depression, and because the diagnosis is based on historical information it is lifelong. Noting that there is evidence that many individuals avoid relapse over long periods of time and could be considered to have recovered, this study aimed to characterise the personal experience of recovery in people with a diagnosis of bipolar disorder. The study recruited a sample of 11 individuals over the age of 30 with a history of bipolar disorder and who had remained free from relapse and without hospitalisation for least 2 years, and used semi-structured interviews designed to elicit responses regarding approaches used to remaining well which were transcribed and analysed. The analysis showed 2 overarching themes each with four themes: ambivalent approaches with both positive and negative consequences (monitoring against mania and avoiding activities that lead to states of activation, medication, prior illness versus current wellness, and sense of identity following diagnosis) and helpful approaches seen as universally helpful (understanding and accepting they have a problem, lifestyle fundamentals that promoted increased balance and stability, support and companionship, social change and increase in social activity). The article discusses the findings and their implications.
Learning to cope together
- Author:
- STRAUGHAN Heather
- Journal article citation:
- Mental Health Today, October 2007, pp.34-36.
- Publisher:
- Pavilion
- Place of publication:
- Hove
This article reports on a 12 week training program, Insight, that was developed by the author from her own experiences of bipolar disorder, and with input from professional therapies. Self-help, peer support and a multi-faceted approach are fundamental to the program which aims to help sufferers learn to manage the complexity of bipolar disorder.
A window of opportunity: a practical guide for developing early intervention in psychosis services
- Author:
- SAINSBURY CENTRE FOR MENTAL HEALTH
- Publisher:
- Sainsbury Centre for Mental Health
- Publication year:
- 2003
- Pagination:
- 87p.,bibliog.
- Place of publication:
- London
Early intervention services can make a big difference in the lives of young people experiencing psychosis for the first time. This guide argues that if the NHS and social services invest new resources in early intervention they will increase young people’s chances of recovering from mental illness. Over time, they can also save money in other services. Young people across the country often wait for more than a year before receiving treatment for psychosis. Many seek help several times before they get treatment. This increases their chances of long-term mental ill health and social exclusion. The report shows that implementing early intervention services means creating a team with the skills to work with young people to help them not just with their mental health problems but with other aspects of their lives, such as education, work and personal relationships.
In sickness and in health: the experiences of friends and relatives caring for people with manic depression
- Authors:
- HILL Robert G., SHEPHERD Geoff, HARDY Pollyanna
- Journal article citation:
- Journal of Mental Health, 7(6), December 1998, pp.611-620.
- Publisher:
- Taylor and Francis
- Place of publication:
- London
Reports on the results of a survey of friends and relatives of members of the Manic Depression Fellowship, the largest mental self-help group in the UK. Results from over 1000 carers are reported regarding the perceived usefulness of professionals, their quality of life and perceived needs in terms of service provision. It is suggested that similar educational packages to those developed for relatives of people with schizophrenia may be useful.
Perspectives on manic depression: a survey of the Manic Depression Fellowship
- Authors:
- HILL Robert Gareth, HARDY Pollyanna, SHEPHERD Geoff
- Publisher:
- Sainsbury Centre for Mental Health
- Publication year:
- 1996
- Pagination:
- 93p.,diags.,bibliogs.
- Place of publication:
- London
UK wide survey of people suffering from manic depression. Issues looked at include: quality of life issues; effects on relatives and friends; and interventions and respondents' perceptions of professionals.