Age of onset of bipolar disorders: A systematic review and meta-analysis

2016 ◽  
Vol 33 (S1) ◽  
pp. S56-S56
Author(s):  
G. de Girolamo ◽  
M. Bani ◽  
J. Dagani ◽  
C. Ferrari ◽  
A. Pastore ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Age Of Onset ◽  
Meta Analysis ◽  
Early Adulthood ◽  
Bipolar Disorders ◽  
Time Frame ◽  
Inclusion Criteria ◽  
Competing Interest ◽  
Mean Differences ◽  
First Contact

IntroductionAlthough the onset of bipolar disorder (BD) is usually estimated in early adulthood (Burke et al., 1990; Kessler et al., 1997), it is still not clear which age-specific triggering factors may contribute to the underlying vulnerability.Objectives/aimsThe present meta-analysis attempts to clarify the number of untreated years of BD, from first symptoms appearance, to first actions carried out by health services (first diagnosis, treatment and hospitalization).MethodsA literature search of three databases PubMed, Web of Science and Psychology and Behavioral Sciences Collection was performed, looking for peer-reviewed publications in English, French, German and Italian language that reported the AOO of BD; the search string adopted was “bipolar and onset”. Standardized mean differences were calculated between (i) mean AOO, operationally defined as onset of first symptoms/episodes, and (ii) mean AOO, operationally defined according to four criteria: first contact with services, date of the diagnosis, first pharmacological treatment, or first hospitalization.ResultsThe searches yielded 8710 articles; 2424 of these articles met the inclusion criteria. A final set of 19 studies presenting multiple definitions of AOO has been analyzed, revealing an overall effect size of 6.96 of untreated years (Cohen's d = 0.65)ConclusionTo our knowledge, this is the first meta-analysis that addresses the definition and the modulation of the AOO in bipolar disorder. Identifying the time-frame of untreated illness is very important for the best planning of timely interventions.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Minor Physical Anomalies in Bipolar Disorder—A Meta-Analysis

2021 ◽  
Vol 12 ◽  
Author(s):  
Eszter Varga ◽  
András Hajnal ◽  
Alexandra Soós ◽  
Péter Hegyi ◽  
Dóra Kovács ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Meta Analysis ◽  
Bipolar Disorders ◽  
Effect Sizes ◽  
Inclusion Criteria ◽  
Weighted Mean ◽  
Quality Of Evidence ◽  
Minor Physical Anomalies ◽  
The Brain

Introduction: Minor physical anomalies (MPAs) may reflect basic neurobiological features underlying bipolar disorders (BPD), as they are sensitive physical indicators of morphogenetic failure of the brain. Despite several researches about the presence of MPAs in BPD, the results are still controversial.Objectives: The aim of the present meta-analysis was to assess the standardized weighted mean effect sizes of MPAs in BPD and to examine if MPAs may be found predominantly in the head and/or facial regions in BPD patients compared to controls (HC).Methods: Four studies, involving 155 patients with BPD, and 187 HC, were involved in the analysis after searching the literature. For the investigation of MPAs in the peripheral (MPA-P) and in the head and facial regions (MPA-CF), two studies involving 121 BPD patients, and 133 HC passed the inclusion criteria.Results: The number of the MPAs in the BPD group was significantly higher compared to HC. Another important finding of the present study is that BPD patients' MPA-P scores do not significantly differ from those of the HC. In contrast, BPD patients' MPA-CF scores were found to be significantly higher compared to HC subjects. It is important to note that there was a low number of eligible publications included, which caused higher heterogeneity.Conclusions: Low quality of evidence suggests that MPAs are more common in patients with BPD than in HC and the higher rate of MPAs is found predominantly in the head and facial regions.

How long is the interval between the onset and the initial management of bipolar disorder? A meta-analysis

2017 ◽  
Vol 41 (S1) ◽  
pp. S13-S13
Author(s):  
G. De Girolamo ◽  
G. Signorini ◽  
J. Dagani ◽  
F. Faustini
Keyword(s):  
Bipolar Disorder ◽  
Age Of Onset ◽  
Meta Analysis ◽  
Sensitivity Analyses ◽  
First Episode ◽  
Initial Management ◽  
Study Heterogeneity ◽  
Meta Regression ◽  
Competing Interest ◽  
Meta Analyses

ObjectiveTo evaluate the length of the interval between the onset and the initial management of bipolar disorder (BD).MethodWe conducted a meta-analysis using the preferred reporting items for systematic reviews and meta-analyses guidelines. Systematic searches located studies reporting estimates of the age of onset (AOO) and indicators of the age at initial management of BD. We calculated a pooled estimate of the interval between AOO and age at management. Factors influencing between-study heterogeneity were investigated using sensitivity analyses, meta-regression, and multiple meta–regression.ResultsTwenty-seven studies, reporting 51 samples and a total of 9415 patients, met the inclusion criteria. The pooled estimate for the interval between the onset of BD and its management was 5–8 years (standardized difference, .53; 95% confidence interval, .45 to .62). There was very high between-sample heterogeneity (I2 ¼ 92.6; Q ¼ 672). A longer interval was found in studies that defined the onset according to the first episode (compared to onset of symptoms or illness) and defined management as age at diagnosis (rather than first treatment or first hospitalization). A longer interval was reported among more recently published studies, among studies that used a systematic method to establish the chronology of illness, among studies with a smaller proportion of bipolar I patients, and among studies with an earlier mean AOO.ConclusionsThere is currently little consistency in the way researchers report the AOO and initial management of BD. However, the large interval between onset and management of BD presents an opportunity for earlier intervention.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Manejo y comorbilidades de los trastornos bipolares en la infancia y adolescencia

2020 ◽  
Vol 63 (6) ◽  
pp. 40-50
Author(s):  
Hugo Enrique Hernández-Martínez ◽  
Marta Georgina Ochoa-Madrigal
Keyword(s):  
Bipolar Disorder ◽  
Key Words ◽  
Child Psychiatry ◽  
Affective Disorders ◽  
Age Of Onset ◽  
Bipolar Disorders ◽  
World Population ◽  
Key Words Bipolar Disorder ◽  
The World ◽  
Cardinal Symptoms

The diagnosis and treatment of bipolar disorders (BPD) in children is currently one of the biggest challenges and area of controversy in the field of child psychiatry. Bipolar disorders encompass several affective disorders that involve alterations in the degree of activity, content and form of thinking that are characterized by biphasic episodes of mood. This group of disorders affect approximately 1% of the world population and begin in youth (the average age of onset of ~20 years). However, in some studies a delay of 5 years has been observed since the presentation of symptoms at the beginning of the treatment. Currently, the diagnosis of TBP in children and adolescents should be based on the same set of symptoms applied to adults, as well as the general principles of the treatment. The research carried out around this disorder has resulted in changes in the conceptualization and approach of this pathology, now conceived as a group of disorders that share changes in mood and other cardinal symptoms, of a chronic and progressive nature that impacts in a negative way in those who suffer them. Key words: Bipolar disorder; childhood; mania; hypomania; depression.

scholarly journals Association between serum visfatin levels and psoriasis and their correlation with disease severity: a meta-analysis

2021 ◽  
Vol 49 (3) ◽  
pp. 030006052110023
Author(s):  
Qian Zou ◽  
Jiawei Si ◽  
Yatao Guo ◽  
Jiayu Yu ◽  
Huijuan Shi
Keyword(s):  
Body Mass Index ◽  
Meta Analysis ◽  
Severity Index ◽  
Cochrane Library ◽  
Control Group ◽  
Inclusion Criteria ◽  
Subgroup Analyses ◽  
Mean Differences ◽  
The Cochrane Library ◽  
Psoriasis Severity

Objective To determine the association between serum visfatin levels and psoriasis and to evaluate the correlation between serum visfatin levels and the severity of psoriasis. Methods The electronic databases PubMed®, Embase® and the Cochrane Library were searched for articles published from inception to 1 May 2020. Data were extracted and then standard mean differences (SMDs) and 95% confidence intervals (CIs) were calculated for pooled estimates. Results A total of 11 studies met the inclusion criteria and were included (448 patients diagnosed with psoriasis and 377 controls). This meta-analysis demonstrated that patients with psoriasis had significantly higher levels of visfatin than the controls (SMD = 0.90, 95% CI 0.52, 1.28). Subgroup analyses showed that differences in serum visfatin levels between the patient group and the control group were associated with ethnicity, Psoriasis Area and Severity Index (PASI) and body mass index. Additionally, a meta-analysis of correlations showed that visfatin levels in patients with psoriasis were positively correlated with PASI ( r = 0.51, 95% CI 0.14, 0.75). Conclusions This meta-analysis showed that serum visfatin levels in patients with psoriasis were significantly higher than those in the controls and a positive correlation between serum visfatin levels and psoriasis severity was observed.

scholarly journals Adjuvant HPV Vaccination to Prevent Recurrent Cervical Dysplasia after Surgical Treatment: A Meta-Analysis

Vaccines ◽  
2021 ◽  
Vol 9 (5) ◽  
pp. 410
Author(s):  
Violante Di Donato ◽  
Giuseppe Caruso ◽  
Marco Petrillo ◽  
Evangelos Kontopantelis ◽  
Innocenza Palaia ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Meta Analysis ◽  
Hpv Vaccination ◽  
Cervical Dysplasia ◽  
Reduction Rate ◽  
Intraepithelial Neoplasia ◽  
Surgical Excision ◽  
Inclusion Criteria ◽  
Mean Differences ◽  
The Impact

Objective: The aim of this meta-analysis was to discuss evidence supporting the efficacy of adjuvant human papillomavirus (HPV) vaccination in reducing the risk of recurrent cervical intraepithelial neoplasia (CIN) 2 or greater after surgical treatment. Methods: A systematic literature search was performed for studies reporting the impact of HPV vaccination on reducing the risk of recurrence of CIN 2+ after surgical excision. Results were reported as mean differences or pooled odds ratios (OR) with 95% confidence intervals (95% CI). Results: Eleven studies met the inclusion criteria and were selected for analysis. In total, 21,310 patients were included: 4039 (19%) received peri-operational adjuvant HPV vaccination while 17,271 (81%) received surgery alone. The recurrence of CIN 2+ after treatment was significantly lower in the vaccinated compared with the unvaccinated group (OR 0.35; 95% CI 0.21–0.56; p < 0.0001). The recurrence of CIN 1+ after treatment was significantly lower in the vaccinated compared with the unvaccinated group (OR 0.51; 95% CI 0.31–0.83; p = 0.006). A non-significant trend of reduction rate of HPV persistence was observed in the vaccinated compared with the unvaccinated cohorts (OR was 0.84; 95% CI 0.61–1.15; p = 0.28). Conclusions: HPV vaccination, in adjuvant setting, is associated with a reduced risk of recurrent CIN 1+ and CIN 2+ after surgical treatment.

Bipolar Disorders: Antipsychotic Drug Therapy of Aripiprazole an Open Label Study

2018 ◽  
Vol 3 (1) ◽  
pp. 01-02
Author(s):  
Amycus Alecto
Keyword(s):  
Bipolar Disorder ◽  
Early Adulthood ◽  
Indirect Costs ◽  
Bipolar Disorders ◽  
Open Label ◽  
Open Label Study ◽  
Label Study ◽  
Direct And Indirect Costs ◽  
The Us ◽  
Depressive Episodes

Patients with bipolar disorder are exceptionally challenging to manage because of the dynamic, chronic, and fluctuating nature of their disease. Typically, the symptoms of bipolar disorder first appear in adolescence or early adulthood, and are repeated over the patient's lifetime, expressed as unpredictable recurrences of hypomanic/manic or depressive episodes. The lifetime prevalence of bipolar disorder in adults is reported to be approximately 4%, and its management was estimated to cost the US healthcare system in 2009 $150 billion in combined direct and indirect costs.

Early and Late Onset Bipolar Disorders in Older Adults

2017 ◽  
Vol 41 (S1) ◽  
pp. S211-S211
Author(s):  
N. Smaoui ◽  
L. Zouari ◽  
N. Charfi ◽  
M. Maâlej-Bouali ◽  
N. Zouari ◽  
...  
Keyword(s):  
Older Adults ◽  
Bipolar Disorder ◽  
Early Onset ◽  
Age Of Onset ◽  
Late Onset ◽  
Age At Onset ◽  
Bipolar Disorders ◽  
Medical Diagnoses ◽  
The Mean ◽  
Bipolar Patients

IntroductionAge of onset of illness may be useful in explaining the heterogeneity among older bipolar patients.ObjectiveTo examine the relationship of age of onset with clinical, demographic and behavioral variables, in older patients with bipolar disorder.MethodsThis was a cross-sectional, descriptive and analytical study, including 24 patients suffering from bipolar disorders, aged 65 years or more and followed-up in outpatient psychiatry unit at Hedi Chaker university hospital in Sfax in Tunisia. We used a standardized questionnaire including socio-demographic, behavioral and clinical data. Age of onset was split at age 40 years into early-onset (< 40 years; n = 12) and late-onset (≥ 40 years; n = 12) groups.ResultsThe mean age for the entire sample was 68.95 years. The mean age of onset was 39.95 years. The majority (60%) of patients were diagnosed with bipolar I. Few meaningful differences emerged between early-onset and late-onset groups, except that tobacco use was significantly higher in the late-onset group (66.6% vs. 16.6%; P = 0.027). No significant differences between the early-onset and late-onset groups were seen on demographic variables, family history and number of medical diagnoses or presence of psychotic features.ConclusionOur study found few meaningful behavioral differences between early versus late age at onset in older adults with bipolar disorder.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Comparison of Carbamazepine and Lithium in the Prophylaxis of Bipolar Disorders

1995 ◽  
Vol 166 (3) ◽  
pp. 378-381 ◽  
Author(s):  
R. Dardennes ◽  
C. Even ◽  
F. Bange ◽  
A. Heim
Keyword(s):  
Bipolar Disorder ◽  
Statistical Power ◽  
Outcome Measure ◽  
Meta Analysis ◽  
Bipolar Disorders ◽  
Quality Score ◽  
Significant Heterogeneity ◽  
Double Blind ◽  
Prophylactic Efficacy ◽  
Statistical Results

BackgroundThis meta-analysis assessed the equipotency of carbamazepine and lithium prophylaxis in bipolar disorder.MethodWe selected only randomised, double-blind, controlled studies comparing carbamazepine with lithium from a manual and computerised search, and subjected them to a quality inventory. Their statistical results were weighted by their quality score and combined. Results. Four studies met our criteria, yielding, overall, P = 0.15. This result is not straightforward because the studies showed significant heterogeneity (P < 0.01).ConclusionDifferences in statistical power and sensitivity of outcome measure explain this heterogeneity and the conflicting results of the studies. Therefore, the prophylactic efficacy of carbamazepine remains questionable.

scholarly journals Acute Exercise and Appetite-Regulating Hormones in Overweight and Obese Individuals: A Meta-Analysis

2016 ◽  
Vol 2016 ◽  
pp. 1-8 ◽  
Author(s):  
Jessica Anne Douglas ◽  
Kevin Deighton ◽  
Jan Maria Atkinson ◽  
Vahid Sari-Sarraf ◽  
David John Stensel ◽  
...  
Keyword(s):  
Acute Exercise ◽  
Peptide Yy ◽  
Meta Analysis ◽  
Area Under The Curve ◽  
Inclusion Criteria ◽  
Analysis Model ◽  
Blood Concentrations ◽  
Glucagon Like Peptide ◽  
Glucagon Like Peptide 1 ◽  
Mean Differences

In lean individuals, acute aerobic exercise is reported to transiently suppress sensations of appetite, suppress blood concentrations of acylated ghrelin (AG), and increase glucagon-like peptide-1 (GLP-1) and peptide-YY (PYY). Findings in overweight/obese individuals have yet to be synthesised. In this systematic review and meta-analysis, we quantified the effects that acute exercise has on AG and total PYY and GLP-1 in overweight/obese individuals. The potential for body mass index (BMI) to act as a moderator for AG was also explored. Six published studies (73 participants, 78% male, mean BMI: 30.6 kg·m−2) met the inclusion criteria. Standardised mean differences (SMDs) and standard errors were extracted for AG and total PYY and GLP-1 concentrations in control and exercise trials and synthesised using a random effects meta-analysis model. BMI was the predictor in metaregression for AG. Exercise moderately suppressed AG area-under-the-curve concentrations (pooled SMD: −0.34, 95% CI: −0.53 to −0.15). The magnitude of this reduction was greater for higher mean BMIs (pooled metaregression slope: −0.04 SMD/kg·m−2 (95% CI: −0.07 to 0.00)). Trivial SMDs were obtained for total PYY (0.10, 95% CI: −0.13 to 0.31) and GLP-1 (−0.03, 95% CI: −0.18 to 0.13). This indicates that exercise in overweight/obese individuals moderately alters AG in a direction that could be associated with decreased hunger and energy intake. This trial is registered with PROSPERO: CRD42014006265.

The Role of Long Acting Antipsychotics in Bipolar Disorder

2017 ◽  
Vol 41 (S1) ◽  
pp. S15-S15
Author(s):  
E. Vieta
Keyword(s):  
Bipolar Disorder ◽  
Meta Analysis ◽  
Term Treatment ◽  
Patient Profile ◽  
Long Term Treatment ◽  
Short And Long Term ◽  
Competing Interest ◽  
Long Acting

Antipsychotics are widely used for the short and long-term treatment of bipolar disorder. Depot and long-acting injectable formulations (LAIs) can be particularly useful for certain subgroups of patients. This lecture will discuss the available data from randomized controlled trials of LAIs in bipolar disorder. A recently published meta-analysis and individual studies assessing depot medications, as well as modern LAIs such as risperidone, paliperidone and aripiprazole, will be reviewed, looking carefully into the prevention of either pole of illness and tolerability. Potential indications and patient profile, based on data and clinical experience, will be discussed.Disclosure of interestThe author has not supplied his declaration of competing interest.

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