Search results for ‘Subject term:"bipolar disorder"’ Sort:
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The role of vascular risk factors in late onset bipolar disorder
- Authors:
- SUBRAMANIAM Hari, DENNIS Michael S., BYRNE E. Jane
- Journal article citation:
- International Journal of Geriatric Psychiatry, 22(8), August 2007, pp.733-737.
- Publisher:
- Wiley
The association between late life depression and cerebro-vascular risk and cerebro-vascular disease is well established. This study aimed to investigate whether similar links exist with late onset bipolar disorder. Patients with early onset (less than 60 years of age) bipolar disorder were compared with those of late onset (aged 60 and above) in relation to cognitive function, physical health and vascular risk factors. Participants were receiving specialist care from the Leicestershire Mental Health NHS Partnership Trust. Thirty patients with early onset were compared with 20 patients with a late onset bipolar disorder. Diagnosis of bipolar disorder was according to ICD-10 criteria and without an associated clinical diagnosis of dementia. Assessment of cognition included tests of frontal-executive function, and cerebro-vascular risk was quantified with the Framingham stroke risk score. The late onset group had a higher stroke risk score than the early onset group, this difference persisting despite taking age and gender differences into account. However, late onset patients' cognitive function (including frontal lobe tests) and physical health status was no different to the early onset group. There is higher cerebrovascular risk in elderly patients with late onset bipolar disorder, compared to patients with an early onset. This suggests that cerebrovascular risk may be an important factor for the expression of bipolar disorders in later life, and has significant management implications for older bipolar patients.
Lithium and risk for Alzheimer's disease in elderly patients with bipolar disorder
- Authors:
- NUNES Paula V., FORLENZA Orestes V., GATTAZ Wagner F.
- Journal article citation:
- British Journal of Psychiatry, 190(4), April 2007, pp.359-360.
- Publisher:
- Cambridge University Press
Bipolar disorder is associated with increased risk for dementia. The authors compared the prevalence of Alzheimer's disease between 66 elderly euthymic patients with bipolar disorder who were on chronic lithium therapy and 48 similar patients without recent lithium therapy. The prevalence of dementia in the whole sample was 19% v. 7% in an age-comparable population. Alzheimer's disease was diagnosed in 3 patients (5%) on lithium and in 16 patients (33%) who were not on lithium.The case–control data suggest that lithium treatment reduced the prevalence of Alzheimer's disease in patients with bipolar disorder to levels in the general elderly population. This is in accordance with reports that lithium inhibits crucial processes in the pathogenesis of Alzheimer's disease.
Attention-deficit hyperactivity disorder and anxiety disorders as precursors of bipolar disorder onset in adulthood
- Authors:
- MEIER Sandra M., et al
- Journal article citation:
- British Journal of Psychiatry, 213(3), 2018, pp.555-560.
- Publisher:
- Cambridge University Press
Background: Attention-deficit hyperactivity disorder (ADHD) and anxiety disorders have been proposed as precursors of bipolar disorder, but their joint and relative roles in the development of bipolar disorder are unknown. Aims: To test the prospective relationship of ADHD and anxiety with onset of bipolar disorder. Method: The relationship between ADHD, anxiety disorders and bipolar disorder in a birth cohort of 2 409 236 individuals born in Denmark between 1955 and 1991 was examined. Individuals were followed from their sixteenth birthday or from January 1995 to their first clinical contact for bipolar disorder or until December 2012. The incidence rates per 10 000 person-years was calculated and tested the effects of prior diagnoses on the risk of bipolar disorder in survival models. Results: Over 37 394 865 person-years follow-up, 9250 onsets of bipolar disorder occurred. The incidence rate of bipolar disorder was 2.17 (95% CI 2.12–2.19) in individuals with no prior diagnosis of ADHD or anxiety, 23.86 (95% CI 19.98–27.75) in individuals with a prior diagnosis of ADHD only, 26.05 (95% CI 24.47–27.62) in individuals with a prior diagnosis of anxiety only and 66.16 (95% CI 44.83–87.47) in those with prior diagnoses of both ADHD and anxiety. The combination of ADHD and anxiety increased the risk of bipolar disorder 30-fold (95% CI 21.66–41.40) compared with those with no prior ADHD or anxiety. Conclusions: Early manifestations of both internalising and externalising psychopathology indicate liability to bipolar disorder. The combination of ADHD and anxiety is associated with a very high risk of bipolar disorder. (Edited publisher abstract)
Risk of dementia and death in community-dwelling older men with bipolar disorder
- Authors:
- ALMEIDA Osvaldo P., et al
- Journal article citation:
- British Journal of Psychiatry, 209(2), 2016, pp.121-126.
- Publisher:
- Cambridge University Press
Background: Bipolar disorder has been associated with cognitive decline, but confirmatory evidence from a community-derived sample of older people is lacking. Aims: To investigate the 13-year risk of dementia and death in older adults with bipolar disorder. Method: Cohort study of 37 768 men aged 65–85 years. Dementia (primary) and death (secondary), as recorded by electronic record linkage, were the outcomes of interest. Results: Bipolar disorder was associated with increased adjusted hazard ratio (HR) of dementia (HR = 2.30, 95% CI 1.80–2.94). The risk of dementia was greatest among those with <5 years of history of bipolar disorder or who had had illness onset after 70 years of age. Bipolar disorder was also associated with increased mortality (HR = 1.51, 95% CI 1.28–1.77). Competing risk regression showed that bipolar disorder was associated with increased hazard of death by suicide, accidents, pneumonia or influenza, and diseases of the liver and digestive system. Conclusions: Bipolar disorder in later life is associated with increased risk of dementia and premature death. (Publisher abstract)
Lost soul
- Author:
- JACKSON Catherine
- Journal article citation:
- Mental Health Today, July 2007, pp.14-15.
- Publisher:
- Pavilion
- Place of publication:
- Hove
This article looks at the last few months of Olivia Trevelyan-Thomas' life, who died alone aged 54, of hypothermia, in her flat on 14 December 2006. She had been taking heavy-duty medication for schizophrenia and bi-polar disorder since she was 20. She was found by police after neighbours alerted them. The article concludes by highlighting the lack of emphasis on safeguarding patients in the community who are risk to themselves.
Mood disorders and migration meta-analysis
- Authors:
- SWINNEN Sanne G. H., SELTEN Jean-Paul
- Journal article citation:
- British Journal of Psychiatry, 190(1), January 2007, pp.6-10.
- Publisher:
- Cambridge University Press
Migration is a risk factor for the development of schizophrenia. The aim was to examine whether migration is also a risk factor for bipolar affective disorder, unipolar depressive disorder and mood disorders in general. Medline was searched for population-based incidence studies concerning mood disorders among migrants and mean relative risks were computed using a mixed-effects statistical model. Only a few studies of unipolar depressive disorder were retrieved. The mean relative risk of developing bipolar affective disorder among migrants was 2.47 (95% CI 1.33–4.59). However, after excluding people of African–Caribbean origin in the UK this risk was no longer significantly increased. The mean relative risk of mood disorders of unspecified polarity was 1.25 (95% CI 1.04–1.49) and that of any mood disorder was 1.38 (95% CI 1.17–1.62). There is no conclusive evidence for a large increase in the risk of mood disorders associated with migration
Mood fluctuations in people putatively at risk for bipolar disorders
- Authors:
- HOFMANN Beate U., MEYER Thomas D.
- Journal article citation:
- British Journal of Clinical Psychology, 45(1), March 2006, pp.105-110.
- Publisher:
- Wiley
The dysregulation of the Behavioural Activation System (BAS) is discussed as a vulnerability marker for bipolar disorders, resulting in fluctuations of activity and mood. People putatively at risk for bipolar disorders (BD) should therefore show mood fluctuations. Using the `Hypomanic Personality Scale' (HPS) three groups of young adults with high (N=17), medium (N=19), and low scores (N=18) were selected and completed a 28-day diary including CES-D and PANAS. People at risk for bipolar disorders exhibited high levels of manic symptoms, positive and negative affect. They also generally reported more mood instability. The results support the hypothesis that fluctuations of mood and symptoms might be a core characteristic of the hypothesized vulnerability for BD. These fluctuations of mood were, however, not restricted to positive affect as a dysregulation of the BAS would suggest.
Bipolar disorder and childbirth: the importance of recognising risk
- Authors:
- JONES Ian, CRADDOCK Nick
- Journal article citation:
- British Journal of Psychiatry, 186(6), June 2005, pp.453-454.
- Publisher:
- Cambridge University Press
Compelling evidence points to women with bipolar disorder being at particularly high risk of puerperal psychosis, with episodes following 25-50% of deliveries. This high rate of illness represents a many hundred-fold increase from the base rate of approximately 1 in 1000 deliveries. In addition to a history of bipolar disorder, other important risk factors include having experienced a previous episode of puerperal psychosis, having a first-degree relative who has experienced an episode of puerperal psychosis and having a first-degree relative with bipolar disorder. Women can be identified, therefore, who are at a vastly increased risk of developing puerperal psychosis - a risk of approximately 60% in women with bipolar disorder and a personal or family history of puerperal psychosis
Current strategies for investigating the genetic and environmental risk factors for affective disorders
- Authors:
- FARMER Anne, ELEY Thalia C., McGUFFIN Peter
- Journal article citation:
- British Journal of Psychiatry, 186(3), March 2005, pp.179-181.
- Publisher:
- Cambridge University Press
It is probable that the genetic components of affective disorders (bipolar affective disorder, major depressive disorder and anxiety states) result from multiple genes conferring susceptibility or liability to develop the disorder when other (environmental) risk factors are also present. In general, bipolar affective disorder has been found to have the highest heritability (the proportion of variance explained by additive genetic factors) of around 80%, followed by major depression (40-70%) and anxiety disorders (40-50%). For affective disorders in adult life the role as precipitants of certain proximal factors such as severe and threatening life events has been well replicated. There is also much evidence of distal factors such as childhood adversity contributing to vulnerability. Important developmental aspects include continuities between childhood depressive symptoms and adult depression and changing contributions of genes and environment throughout the life span. For example, recent findings support and extend earlier work that has shown increasing genetic influence on depressive symptoms as children grow into adolescence. With the completion of the sequencing of all the base pairs in the human genome we are entering a ‘post-genomic’ era, although identifying the genes involved in the aetiology of affective disorders remains a major research pre-occupation. However, many geneticists as well as researchers from other disciplines are turning their attention to environmental risk factors and how these interact and co-act with genes to lead to the expression of pathological phenotypes such as depression. Although genetic variation in humans can now be determined relatively easily from a single DNA sample derived from blood or even scrapings from the inside of the cheek, experimental manipulation of the environment of human subjects is clearly not possible. Consequently, alternative methods are required to measure the ‘environment’. One is to examine the genotypes of individuals who have all been exposed to a specific risk factor, such as childhood adversity or severe threatening life events, comparing those who have expressed the phenotype, for example by becoming depressed, and those who have not (resilient individuals). Some longitudinal and twin studies, as well as others currently being conducted, will lend themselves to this type of analysis.
Course of illness in depressive and bipolar
- Authors:
- KESSING Lars Vedel, HANSEN Mette Gerster, ANDERSEN Per Hragh
- Journal article citation:
- British Journal of Psychiatry, 185(11), November 2004, pp.372-377.
- Publisher:
- Cambridge University Press
Newer antidepressants have increasingly been used during the past decade. These drugs may increase compliance and reduce the risk of cycle acceleration in affective disorders. The aim as to investigate the naturalistic longitudinal course of illness in patients with depressive or bipolar disorder following the use of recently introduced drugs. The rates of relapse leading to hospitalisation after successive episodes were calculated in a case register study including all hospital admissions of patients with primary affective disorder in Denmark during 1994–1999. Altogether, 9417 patients had a diagnosis of depressive disorder and 1106 patients had a diagnosis of mania or bipolar disorder, at first-ever discharge. The rate of relapse leading to hospitalisation increased with the number of previous episodes in both depressive and bipolar disorders. However, the effect of episodes was not significant for men. The rate of relapse did not decline during the study period. The course of severe depressive and bipolar disorders has remained roughly the same despite introduction of new treatments