Work impairment in bipolar disorder patients – results from a two-year observational study (EMBLEM)

2010 ◽  
Vol 25 (6) ◽  
pp. 338-344 ◽  
Author(s):  
C. Reed ◽  
I. Goetz ◽  
E. Vieta ◽  
M. Bassi ◽  
J.M. Haro ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Observational Study ◽  
Related Factor ◽  
Related Factors ◽  
Work Impairment ◽  
Factors Associated ◽  
Multivariate Modelling ◽  
Baseline Factors ◽  
High Work

AbstractObjectivesTo explore factors associated with work impairment at 2 years following an acute episode.MethodsEuropean Mania in Bipolar disorder Longitudinal Evaluation of Medication (EMBLEM) is a prospective, observational study on the outcomes of patients with a manic/mixed episode. Work impairment was measured using a Longitudinal Interval Follow-up Evaluation (slice of LIFE) item and patients were categorised with either low or high work impairment at each observation. Baseline factors associated with work impairment at 2 years were assessed using multivariate modelling.ResultsAt baseline (n = 2289), 69% of patients had high work impairment. At 2 years (n = 1393), high impairment reduced to 41%. Modelling identified rapid cycling as the strongest disease-related factor associated with high work impairment at 2 years, although high work impairment at baseline had the strongest association overall. Lower levels of education, recent admissions, CGI-BP overall severity in the 12 months prior to baseline and CGI-BP mania at baseline all predicted higher work impairment. Living together in a relationship and independent housing were both significantly associated with having low work impairment at 2 years.ConclusionsWork impairment in bipolar disorder is maintained over long periods, and is strongly associated with relationship status, living conditions and various disease-related factors.

Factors associated with the course of symptoms in bipolar disorder during a 1-year follow-up: Depression vs. sub-threshold mixed state

2011 ◽  
Vol 65 (6) ◽  
pp. 419-426 ◽  
Author(s):  
Marianna Mazza ◽  
Laura Mandelli ◽  
Leonardo Zaninotto ◽  
Marco Di Nicola ◽  
Giovanni Martinotti ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Mixed State ◽  
Factors Associated

scholarly journals Maternal Risk Factors Associated with Poor Postpartum Healthcare Utilization

2020 ◽  
Author(s):  
michael e silverman ◽  
Holly Loudon ◽  
Laudy Burgos
Keyword(s):  
Mount Sinai Hospital ◽  
Population Based ◽  
Postpartum Care ◽  
Related Factors ◽  
Maternal Risk ◽  
Factors Associated ◽  
Ambulatory Practice ◽  
Mount Sinai ◽  
Prenatal Visits

Abstract Objectives: Perceptions regarding the benefits of postpartum care among mothers and clinicians often differ. Clinicians generally perceive postpartum care as preventative, whereas pregnant and postpartum women often lack knowledge about its preventative benefits. As a result many women choose not to return for scheduled postpartum care visits. Methods: To examine if clinically relevant demographic and birth related factors are informative predictors for postpartum healthcare follow-up care, we conducted a population based cohort study of all women who delivered a child in 2012 – 2015 at the New York Mount Sinai Hospital Obstetrics and Gynecology Ambulatory Practice. Data was ascertained from electronic health records.Results: Of the 4,240 unique women who delivered between 2012-2015 at the Mount Sinai Hospital OB/GYN Ambulatory Practice, 1,685 (39.7%) did not return for their postpartum care follow-up appointment. The number of prenatal visits, maternal age, and parity were significantly associated with postpartum care follow-up. Conclusion for Practice: The purpose of this study was to determine identifiable factors associated with reduced postpartum healthcare follow-up utilization. Several clinically relevant variables were associated with the reduced likelihood for attending postpartum care visits. Because pregnant women represent a medically captured population, the results of this study point to the need to increase postpartum healthcare literacy during perinatal appointments especially among younger mothers, women who have had previous deliveries, and those with fewer prenatal visits.

scholarly journals Factors Associated with Persistence with Teriparatide Therapy: Results from the DANCE Observational Study

2011 ◽  
Vol 2011 ◽  
pp. 1-7 ◽  
Author(s):  
Deborah T. Gold ◽  
David L. Weinstein ◽  
Gerhardt Pohl ◽  
Kelly D. Krohn ◽  
Yi Chen ◽  
...  
Keyword(s):  
Side Effects ◽  
Observational Study ◽  
Trend Test ◽  
Factors Associated ◽  
Treatment Side Effects ◽  
Patient Reported ◽  
Proper Training ◽  
Improper Use ◽  
Armitage Trend Test

Purpose. Determine patient-reported reasons for discontinuation with teriparatide.Methods. Patients taking teriparatide in a multicenter, prospective, and observational study were given three questionnaires: baseline, follow-up questionnaire 1 (QF1, 2 to 6 months), and follow-up questionnaire 2 (QF2, 12 months). Discontinuation reported at QF1 and QF2 was defined as “early” and “late,” respectively, and remaining patients were considered persistent. Cochran-Armitage trend test was used to identify factors associated with discontinuation.Results. Side effects, concern about improper use, injection difficulties, and several patient-perceived physician issues were associated with early discontinuation. Low patient-perceived importance of continuing treatment, side effects, difficulty paying, and low patient-perceived physician knowledge were associated with late discontinuation. The most common specific reasons selected for discontinuing treatment were “concerns about treatment outweighing the benefits” (n=53) and “difficulty paying” (n=47).Conclusions. Persistence with teriparatide is dependent on managing side effects, addressing financial challenges, proper training, and obtaining support from the healthcare provider.

scholarly journals OP0052 FACTORS ASSOCIATED WITH REMISSION AT 5 YEARS OF FOLLOW-UP IN EARLY ONSET AXIAL SPONDYLOARTHRITIS: RESULTS FROM THE DESIR COHORT

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 27.1-28
Author(s):  
L. Pina Vegas ◽  
E. Sbidian ◽  
D. Wendling ◽  
P. Goupille ◽  
S. Ferkal ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Ankylosing Spondylitis ◽  
Disease Activity ◽  
Activity Index ◽  
Sensitivity Analyses ◽  
Factors Associated ◽  
Tnfα Inhibitors ◽  
Baseline Factors ◽  
Active Disease

Background:The disease course of axial SpA (axSpA) is highly variable and can be characterized by ongoing axial inflammation and radiographic progression associated with restricted mobility of the spine, reduced function and disability leading to impairment in quality of life. Control of disease activity is a primary aim in axSpA management. To assess disease activity the Ankylosing Spondylitis Disease Activity Score-C-reactive protein (ASDAS-CRP) is often considered as a reference tool. The data on remission are spare in axSpA and the identification of long-term remission factors, enabling the patient’s management to be adapted, seems necessary but remains unclear.Objectives:To evaluate the proportion of patients in remission according to ASDAS-CRP at 5 years of follow-up, to describe their characteristics in comparison with patients with active disease at that time, and to identify baseline factors associated with remission at 5 years of follow-up.Methods:We included all patients from the DESIR (Devenir des Spondylarthropathies Indifférenciées Récentes) cohort with available data on ASDAS-CRP at 5-year follow-up and TNFα inhibitors exposure. Patients in remission, defined as an ASDAS-CRP<1.3, and with active disease were compared according to their main demographic, clinical, biological and radiological characteristics. A logistic model stratified on TNFα inhibitors exposure was used in the main analysis. Sensitivity analyses among patients with axSpA diagnosis confirmed by rheumatologist at 5-years were performed.Results:A total of 614 patients were followed in the DESIR cohort at M60. After excluding those with missing data on ASDAS score (n= 163) and TNFα inhibitors exposure (n= 2), analyzed patients were 449 (73%). Excluded patients had similar baseline characteristics to those included in the analysis. Among patients unexposed to TNFα inhibitors (n=247), 77 (31%) were in remission (37,8±8,3 years; 55% men, 58% NSAID users), 170 (69%) weren’t (39,8±8,6 years; 42% men, 81% NSAID users). Among exposed patients (n=202), 34 (17%) were in remission (36,1±8,1 years; 71% men, 29% NSAID users), 168 (83%) weren’t (39,5±9,0 years; 41% men, 63% NSAID users) (Figure 1). Overall, patients in remission were more frequently men, HLA-B27+, with high education and lower BMI at 5-year of follow-up. The baseline factors associated with remission at 5 years of follow-up from the multivariate analysis are presented in Table 1.Table 1.Baseline factors associated with remission at 5-year follow-up (multivariate analysis)TNFα: Tumor Necrosis Factor alpha; ORa: adjusted Odd Ratio; 95%IC: 95% confidence interval; BASDAI: Bath Ankylosing Spondylitis Disease Activity Index; BMI: Body Mass Index.Conclusion:The overall remission rate at 5 years was 25%, 31% among patients unexposed to TNFα inhibitors and 17% among those exposed. This study reveals the difficulty in achieving 5-year remission in recent axSpA, especially in the most active forms at baseline; socio-educational factors and overweight also appear to be related.Acknowledgements:L Pina Vegas received a Master 2 grant from the French Society of Rheumatology (Bourse Master 2ème Année 2019)Disclosure of Interests:Laura Pina Vegas: None declared, Emilie Sbidian: None declared, Daniel Wendling: None declared, Philippe Goupille: None declared, Salah Ferkal: None declared, Philippe Le Corvoisier: None declared, Bijan Ghaleh: None declared, Alain Luciani: None declared, Pascal Claudepierre Speakers bureau: Abbvie, Janssen, Lilly, MSD, Novartis, Pfizer, Consultant of: Abbvie, Pfizer, Roche-Chugai, Bristol-Myers Squibb, MSD, UCB, Novartis, Janssen, Lilly, Celgene (consulting fees, less than 10,000 $ each)., Employee of: Roche Chugai, Sanofi Aventis, Celgene, Pfizer, MSD, Novartis and BMS (investigator).

scholarly journals Prevalence, injury-, and non-injury-related factors associated with anxiety and depression in polytrauma patients – A retrospective 20 year follow-up study

PLoS ONE ◽  
2020 ◽  
Vol 15 (5) ◽  
pp. e0232678
Author(s):  
Sascha Halvachizadeh ◽  
Henrik Teuber ◽  
Till Berk ◽  
Florin Allemann ◽  
Roland von Känel ◽  
...  
Keyword(s):  
Anxiety And Depression ◽  
Related Factors ◽  
Factors Associated ◽  
Follow Up Study ◽  
Polytrauma Patients

scholarly journals Early clinical predictors and correlates of long-term morbidity in bipolar disorder

2017 ◽  
Vol 43 ◽  
pp. 35-43 ◽  
Author(s):  
G. Serra ◽  
A Koukopoulos ◽  
L. De Chiara ◽  
A.E. Koukopoulos ◽  
G. Sani ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Psychiatric Comorbidity ◽  
First Episode ◽  
Clinical Predictors ◽  
Factors Associated ◽  
Psychiatric Syndrome ◽  
Linear Regression Modeling ◽  
Depressive Episodes

AbstractObjectives:Identifying factors predictive of long-term morbidity should improve clinical planning limiting disability and mortality associated with bipolar disorder (BD).Methods:We analyzed factors associated with total, depressive and mania-related long-term morbidity and their ratio D/M, as %-time ill between a first-lifetime major affective episode and last follow-up of 207 BD subjects. Bivariate comparisons were followed by multivariable linear regression modeling.Results:Total % of months ill during follow-up was greater in 96 BD-II (40.2%) than 111 BD-I subjects (28.4%; P = 0.001). Time in depression averaged 26.1% in BD-II and 14.3% in BD-I, whereas mania-related morbidity was similar in both, averaging 13.9%. Their ratio D/M was 3.7-fold greater in BD-II than BD-I (5.74 vs. 1.96; P < 0.0001). Predictive factors independently associated with total %-time ill were: [a] BD-II diagnosis, [b] longer prodrome from antecedents to first affective episode, and [c] any psychiatric comorbidity. Associated with %-time depressed were: [a] BD-II diagnosis, [b] any antecedent psychiatric syndrome, [c] psychiatric comorbidity, and [d] agitated/psychotic depressive first affective episode. Associated with %-time in mania-like illness were: [a] fewer years ill and [b] (hypo)manic first affective episode. The long-term D/M morbidity ratio was associated with: [a] anxious temperament, [b] depressive first episode, and [c] BD-II diagnosis.Conclusions:Long-term depressive greatly exceeded mania-like morbidity in BD patients. BD-II subjects spent 42% more time ill overall, with a 3.7-times greater D/M morbidity ratio, than BD-I. More time depressed was predicted by agitated/psychotic initial depressive episodes, psychiatric comorbidity, and BD-II diagnosis. Longer prodrome and any antecedent psychiatric syndrome were respectively associated with total and depressive morbidity.

Adherence with Antipsychotic Treatment Medication in Outpatients with Schizophrenia: 36- Month Results from the Schizophrenia Outpatients Health Outcomes (soho) Study

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
D. Novick ◽  
D. Suarez ◽  
J.M. Haro ◽  
P.M. Haddad
Keyword(s):  
Substance Abuse ◽  
Medication Adherence ◽  
Alcohol Dependence ◽  
Antipsychotic Medication ◽  
List Type ◽  
Factors Associated ◽  
Long Term Treatment ◽  
Baseline Factors ◽  
First Time

Objective:To assess frequency and baseline factors associated with adherence with antipsychotic medication during long-term treatment in outpatients with schizophrenia.Methods:SOHO is a 3-year, prospective, observational study that included 10 972 patients changing or starting a new antipsychotic medication Treatment adherence during 4 weeks prior to the visit was assessed at each visit by participating psychiatrists as:•the patient has not been prescribed medication;•the patient almost always adheres;•the patient adheres half of the time; and•the patient never adheres to antipsychotic medication.Logistic regression models were fitted to analyze the baseline factors associated to compliance during follow-up.Results:6731 patients with at most one missing visit were analysed. Data from the missing visit were imputed from the previous visit; 71.2% were considered to be adherent and 28.8% non-adherent over the 3-year follow-up period. the strongest predictor of medication adherence during follow-up was adherence at baseline (OR = 4.01, 95% CI: 3.46-4.64). other baseline predictors of adherence included not using antipsychotics in the previous 4 weeks, receiving treatment for first time, being socially active, and a higher body mass index. Baseline predictors of non-adherence were alcohol dependence, substance abuse, hospitalisation in previous 6 months, living independently housing and having hostile behaviours.Conclusions:Alcohol dependence, substance abuse and living independently were associated with non-adherence. Previous adherence, being socially active and receiving medication for the first time was associated with better adherence. Limitation: medication adherence was assessed by the psychiatrist through a single item question.

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