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Book

Perspective on manic depression: a survey of the manic depression fellowship

Authors:
HILL R., HARDY P., SHEPHERD G
Publisher:
Sainsbury Centre for Mental Health
Publication year:
1995
Journal article

Does age at onset have clinical significance in older adults with bipolar disorder?

Authors:
CHU David, et al
Journal article citation:
International Journal of Geriatric Psychiatry, 25(12), December 2010, pp.1266-1271.
Publisher:
Wiley-Blackwell

Using data from the Bipolar Disorder Center for Pennsylvanians Study, a randomised controlled study of people with bipolar disorder, this analysis looked at factors including demographics, psychopathology and treatment response to examine the effects of age at onset in bipolar disorder in older adults. The analysis covered 61 subjects aged 60 years and older, grouped by early (less than 40 years) or late (more than 40 years) age at onset. The groups were compared on psychiatric comorbidity, medical burden, and percentage of days well during study participation. The results showed that patients with early and late onset experienced similar percentages of days well, while those with early onset had a slightly higher percentage of days depressed than those with late onset. The researchers concluded that distinguishing older adults with bipolar disorder by early or late age at onset has limited clinical usefulness.

Journal article Full text available online for free

Empirical typology of bipolar l mood episodes

Authors:
SOLOMON David A., et al
Journal article citation:
British Journal of Psychiatry, 195(6), December 2009, pp.525-530.
Publisher:
Royal College of Psychiatrists

The typology of bipolar I disorder, that is the different types of mood episodes that occur over time, was measured empirically. It is hoped that studying the phenotypes will have a direct impact on diagnosis, treatment and prognosis and will help specify the genetic aetiology and pathophysiology of the disorder. Two hundred and nineteen individuals from the United States with Research Diagnostic Criteria bipolar I disorder were assessed for type and frequency of mood episodes over 25 years. In total 1208 mood episodes were recorded as follows: major depression 30.9%; minor depression 13.0%; mania 20.4%; hypomania 10.4%; cycling 17.3%; cycling plus mixed state 7.8% and mixed 0.2%. Major depression was the most common outcome.  Since cycling episodes constituted over 25% of all episodes, the authors concluded that workgroups should formally recognise bipolar I cycling episodes as a category when revising ICD-10 and DSM-IV. The length of follow-up in this study, up to 25 years, is important as it gave investigators better access to individuals with multiple, long mood episodes and multiple, long episodes of euthymia.

Book

Double trouble: living with manic depression: a personal story and a practical guide

Author:
RHODES Pauline
Publisher:
Fourems
Publication year:
2007
Pagination:
76p.
Place of publication:
Hertford

An account of the realities of living with bipolar disorder. The author began to suffer from this disorder following the traumatic birth of her twins. The death of her father and subsequent illness of her mother prompted a further spell and the death of her mother another relapse. The book covers living with the illness in and out of psychiatric units, and sources of comfort including music, silk painting and writing. It also covers the religious question, conventional and alternative therapies (acknowledging the value of drugs while pointing out the need to be careful of drugs which may have an interaction), exercise, and work including volunteering, training, including gaining a Distinction in the Certificate in Interpersonal Skills for Volunteers at the University of Wales, Lampeter, and eventually working for ‘Rethink’. The author acknowledges the ways in which the illness has enriched her life by widening insight into the power of the human mind and enabling empathy with others suffering from severe mental illness. She also pays tribute to her family and offers some practical self-help for depression.

Journal article Full text available online for free

Mortality gap for people with bipolar disorder and schizophrenia: UK-based cohort study 2000–2014

Authors:
HAYES Joseph F., et al
Journal article citation:
British Journal of Psychiatry, 211(3), 2017, pp.175-181.
Publisher:
Royal College of Psychiatrists

Background: Bipolar disorder and schizophrenia are associated with increased mortality relative to the general population. There is an international emphasis on decreasing this excess mortality. Aims: To determine whether the mortality gap between individuals with bipolar disorder and schizophrenia and the general population has decreased. Method: A nationally representative cohort study using primary care electronic health records from 2000 to 2014, comparing all patients diagnosed with bipolar disorder or schizophrenia and the general population. The primary outcome was all-cause mortality. Results: Individuals with bipolar disorder and schizophrenia had elevated mortality (adjusted hazard ratio (HR) = 1.79, 95% CI 1.67–1.88 and 2.08, 95% CI 1.98–2.19 respectively). Adjusted HRs for bipolar disorder increased by 0.14/year (95% CI 0.10–0.19) from 2006 to 2014. The adjusted HRs for schizophrenia increased gradually from 2004 to 2010 (0.11/year, 95% CI 0.04–0.17) and rapidly after 2010 (0.34/year, 95% CI 0.18–0.49). Conclusions: The mortality gap between individuals with bipolar disorder and schizophrenia, and the general population is widening. (Publisher abstract)

Journal article

Psychological mechanisms and the ups and downs of personal recovery in bipolar disorder

Authors:
DODD Alyson L., et al
Journal article citation:
British Journal of Clinical Psychology, 56(3), 2017, pp.310-328.
Publisher:
Wiley-Blackwell

Background: Personal recovery is recognized as an important outcome for individuals with bipolar disorder (BD) and is distinct from symptomatic and functional recovery. Recovery-focused psychological therapies show promise. As with therapies aiming to delay relapse and improve symptoms, research on the psychological mechanisms underlying recovery is crucial to inform effective recovery-focused therapy. However, empirical work is limited. This study investigated whether negative beliefs about mood swings and self-referent appraisals of mood-related experiences were negatively associated with personal recovery. Design: Cross-sectional online survey. Method: People with a verified research diagnosis of BD (n = 87), recruited via relevant voluntary sector organizations and social media, completed online measures. Pearson's correlations and multiple regression analysed associations between appraisals, beliefs, and recovery. Results: Normalizing appraisals of mood changes were positively associated with personal recovery. Depression, negative self-appraisals of depression-relevant experiences, extreme positive and negative appraisals of activated states, and negative beliefs about mood swings had negative relationships with recovery. After controlling for current mood symptoms, negative illness models, being employed and recent experience of depression predicted recovery. Limitations: Due to the cross-sectional design, causality cannot be determined. Participants were a convenience sample primarily recruited online. Power was limited by the sample size. Conclusions: Interventions aiming to empower people to feel able to manage mood and catastrophize less about mood swings could facilitate personal recovery in people with BD, which might be achieved in recovery-focused therapy. (Edited publisher abstract)

Journal article

‘Listen, empower us and take action now!’: reflexive-collaborative exploration of support needs in bipolar disorder when ‘going up’ and ‘going down’

Authors:
BILLSBOROUGH Julie, et al
Journal article citation:
Journal of Mental Health, 23(1), 2014, pp.9-14.
Publisher:
Informa Healthcare
Place of publication:
London

Background: People with a diagnosis of bipolar disorder experience mood fluctuation from depression to mania, and their support needs may differ during these fluctuations. Aims: To investigate support needed during periods of mania and depression, and when ‘going up’ or ‘going down’. Method: Five service user researchers were supported in a reflexive-collaborative approach to undertake and analyse semi-structured interviews with 16 people with a diagnosis of bipolar disorder and 11 people providing informal support. Results: Support needs differed when becoming manic or depressed. When manic, people needed a calming approach and encouragement to avoid overly stimulating activities. When depressed, positive activity and engaging in everyday life routines were helpful. Three core themes determined the effectiveness of support: (1) being listened to with active engagement through affirmation and encouragement, (2) empowerment through development of personal coping and self-management strategies, and (3) early action and understanding of early warning signs to respond to developing crises and protect wellbeing. Conclusion: Periods of depression or mania, and lesser ‘ups’ and ‘downs’, all require different support needs. Active listening and engagement, facilitating empowerment and appropriate early action are crucial elements of effective support. (Publisher abstract)

Journal article

The role of work in recovery from bipolar disorders

Authors:
BORG Marit, et al
Journal article citation:
Qualitative Social Work, 12(3), 2013, pp.323-339.
Publisher:
Sage

This study examines the role of work in recovery from bipolar disorders seeks to understand how people with such disorders deal with work-related challenges. Semi-structured, qualitative interviews were conducted with persons who had experienced recovery from bipolar disorder. Seven women and six men from Norway participated in the study, ranging in age between 27–65 years old with a mean age of 47 years. Six of the participants had ordinary work, whereas most of the other seven reported participating in regular activities in which some of them were work-like and provided them with some income. Analysis was performed through thematic and phenomenological analysis, with hermeneutic phenomenology and reflexive methodology as a framework. The findings are presented through the following themes: 1) many types of work, finding meaning and a focus; 2) helpful roles and contexts, to be much more than a person with an illness; 3) making work possible, the role of supportive relationships and supportive medications, and 4) the costs of working too much, finding a meaningful and healthy balance. (Edited publisher abstract)

Journal article

Religion and spirituality in the context of bipolar disorder: a literature review

Authors:
PESUT Barbara, et al
Journal article citation:
Mental Health Religion and Culture, 14(8), 2011, pp.785-796.
Publisher:
Taylor and Francis
Place of publication:
Philadelphia, USA

Religion and spirituality (R/S) may play an important role by providing a means of coping with, and an explanatory model for, their disorder in individuals with bipolar disorder (BD). The authors also point out that R/S delusions can be important symptoms of BD.  They conducted a systematic review of empirical studies that explored R/S in individuals with BD or samples that explicitly delineate individuals with BD. Only six studies met the inclusion criteria. Findings from these suggest that R/S strategies may be important for some people in the management of BD. The authors suggest that this means religion and spirituality become relevant concerns for a therapeutic regime that seeks to develop wellness within a bio-psycho-social model. However, they note that the limited body of research and methodological shortcomings of existing research make it difficult to draw conclusions about how this might be accomplished. There is a need for longitudinal, prospective, mixed methods research in order to inform evidence-based practice.

Journal article

Catatonia in a woman who is profoundly deaf-mute: case report

Authors:
AKINTOMIDE Gbolagade, PORTER Stuart Williams, PIERCE Anita
Journal article citation:
Psychiatrist (The), 36(11), November 2012, pp.418-421.
Publisher:
Royal College of Psychiatrists

The authors suggest that catatonia is a common, but underrecognised, complication of bipolar disorder, with a quarter of in-patients with bipolar disorder developing the condition. Almost 9 million people in the UK are deaf or have a significant hearing problem and British Sign Language is the preferred language of 50 000-70 000 people within the UK. At the normal population rate, between 1 and 2% of these individuals will experience bipolar disorder in their lifetime, emphasising the importance of the accurate diagnosis of catatonia. This paper reports a case of catatonia presenting with dysphagia in a 48 year old profoundly deaf-mute woman with bipolar disorder. The report highlights some modifications of presentation and difficulties of accurate diagnosis and management of catatonia in this patient. She responded poorly to diazepam and was eventually prescribed emergency electroconvulsive therapy with some success. Arrival at a diagnosis required interdisciplinary collaboration among a wide range of professionals. This is believed to be the first case report of catatonia in someone who is profoundly deaf-mute.

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