Gender differences in dual bipolar disorder

2017 ◽  
Vol 41 (S1) ◽  
pp. S477-S478
Author(s):  
G. Mateu-Codina ◽  
R. Sauras-Quetcuti ◽  
A. Farre-Martinez ◽  
L. Galindo-Guarín ◽  
J. Marti-Bonany ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Borderline Personality ◽  
Dually Diagnosed ◽  
Sociodemographic Differences ◽  
Co Morbidity ◽  
Severity Scores ◽  
Substance Abuse Disorders ◽  
Dsm Iv ◽  
Competing Interest ◽  
Image Position

IntroductionWomen with bipolar disorder are more prone to psychiatric co-morbidity as anxiety, substance use disorders, eating disorders and borderline personality disorder. Nevertheless, substance abuse disorders as co-morbidity in bipolarity are higher in males than females.ObjectivesTo describe differential characteristics of patients admitted to a psychiatric unit referring to gender in a group of patients with bipolar disorder co-morbid with substances disorders (dually diagnosed patients).MethodsSociodemographic, clinical and administrative data of all patients diagnosed with bipolar admitted to a dual diagnosis during a 3-year period were collected. The psychiatric diagnosis was made according to DSM-IV-R criteria.ResultsFrom the whole sample (n = 66), males (84.8%) were prevalent. Mean age were 37.71 ± 11.7 and mean length of admission was 24.94 ± 17.9 days. Cannabis (34.8%) and cocaine (33.3%) were the most frequent SUD diagnosis and main reasons for admittance were conduct disorder (33.3%) and mania (25.8%).Women showed higher length of admission, higher severity scores at admission and greater reduction in severity scores along hospitalisation. No other clinical or sociodemographic differences were found comparing both groups of patients (Tables 1–4).ConclusionsWomen affected by dual bipolar disorder showed higher severity scores at admission but achieved better remission rates during hospitalisation.Table 1Demographic characteristics of both groups.Table 2Clinical and functional variables at admission in both groups.Table 3Historical data about age of drug use in both groups.Table 4Severity Scores for both groups of study.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Twelve-month prevalence and disability of DSM-IV bipolar disorder in an Australian general population survey

2004 ◽  
Vol 34 (5) ◽  
pp. 777-785 ◽  
Author(s):  
P. B. MITCHELL ◽  
T. SLADE ◽  
G. ANDREWS
Keyword(s):  
Bipolar Disorder ◽  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
National Survey ◽  
Large Scale ◽  
Well Being ◽  
Major Depressive ◽  
Co Morbidity ◽  
Dsm Iv ◽  
Days Out Of Role

Background. There have been few large-scale epidemiological studies which have examined the prevalence of bipolar disorder. The authors report 12-month prevalence data for DSM-IV bipolar disorder from the Australian National Survey of Mental Health and Well-Being.Method. The broad methodology of the Australian National Survey has been described previously. Ten thousand, six hundred and forty-one people participated. The 12-month prevalence of euphoric bipolar disorder (I and II) – similar to the euphoric-grandiose syndrome of Kessler and co-workers – was determined. Those so identified were compared with subjects with major depressive disorder and the rest of the sample, on rates of co-morbidity with anxiety and substance use disorders as well as demographic features and measures of disability and service utilization. Polychotomous logistic regression was used to study the relationship between the three samples and these dependent variables.Results. There was a 12-month prevalence of 0·5% for bipolar disorder. Compared with subjects with major depressive disorder, those with bipolar disorder were distinguished by a more equal gender ratio; a greater likelihood of being widowed, separated or divorced; higher rates of drug abuse or dependence; greater disability as measured by days out of role; increased rates of treatment with medicines; and higher lifetime rates of suicide attempts.Conclusions. This large national survey highlights the marked functional impairment caused by bipolar disorder, even when compared with major depressive disorder.

Asenapine in the treatment of trichotillomania with comorbid bipolar disorder: A case report

2017 ◽  
Vol 41 (S1) ◽  
pp. S683-S683
Author(s):  
B. Francis ◽  
S.T. Jambunathan ◽  
J.S. Gill
Keyword(s):  
Bipolar Disorder ◽  
Poor Sleep ◽  
Hair Pulling ◽  
The Past ◽  
Co Morbidity ◽  
Receptor Profile ◽  
Mood Lability ◽  
Competing Interest ◽  
Disorder Type

Trichotillomania has been found to be associated with mood disorders, particularly bipolar disorder. Trichotillomania has shared similarities with bipolar disorder by virtue of phenomenology, co-morbidity, and psychopharmacologic observations. In the past, trichotillomania with comorbid bipolar disorder was treated with lithium and sodium valproate. There has been little, if any, literature on using asenapine to augment treatment in patients with trichotillomania with comorbid bipolar disorder. A patient presented with hair-pulling episodes for a year, resulting in bald scalp patches. She had no mood symptoms prior to this. She developed low mood, anhedonia, poor sleep and poor appetite subsequently as she could not stop pulling her hair. She was started on escitalopram 10 mg daily for he depressive symptoms. Three years later, she developed hypomanic symptoms such as irritability and spending sprees. Her hair pulling behaviour worsened at this time. At this point, a diagnosis of bipolar disorder type 2 was considered and she was started on lithium 300 mg daily. Her escitalopram was discontinued. As her mood was still labile 10 months later, asenapine was added to augment lithium in the treatment of the bipolar disorder. With asenapine, her hair pulling frequency started to decrease rapidly. Asenapine was increased to 10 mg daily and her hair pulling ceased. Her mood also stabilized and she no longer had erratic periods of mood lability. In conclusion, asenapine augmentation of lithium has potential to be used in patients who have trichotillomania with comorbid bipolar disorder due to its unique receptor profile.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Pharmacotherapy of Bipolar I Disorder: Focus on Aripiprazole

2009 ◽  
Vol 1 ◽  
pp. CMT.S2238
Author(s):  
Leo Bastiaens
Keyword(s):  
Bipolar Disorder ◽  
Treatment Options ◽  
Borderline Personality ◽  
Tolerability Profile ◽  
Metabolic Disturbances ◽  
Good Tolerability ◽  
Hyperactivity Disorder ◽  
Good Tolerability Profile ◽  
Co Morbidity ◽  
Chronic Course

Bipolar disorder is a common and complex condition, starting early in life and continuing throughout the life cycle. Most people suffering from bipolar disorder manifest other problems as well, including metabolic disturbances, cardiovascular disease, anxiety disorders, substance use disorders, attention deficit hyperactivity disorder, and borderline personality disorder, among others. The treatment of bipolar disorder needs to be conceptualized within this context of early onset, chronic course, and significant co-morbidity. Because of its unique mode of action, its efficacy and its good tolerability profile, aripiprazole is well placed among the different treatment options to benefit the patient with bipolar disorder. This article will focus on aripiprazole's pharmacology, efficacy, effectiveness, and tolerability from a clinical perspective, while considering the complexities of bipolar disorder.

scholarly journals Thought disorder in the meta-structure of psychopathology

2012 ◽  
Vol 43 (8) ◽  
pp. 1673-1683 ◽  
Author(s):  
K. M. Keyes ◽  
N. R. Eaton ◽  
R. F. Krueger ◽  
A. E. Skodol ◽  
M. M. Wall ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
General Population ◽  
Personality Disorders ◽  
Thought Disorder ◽  
Patient Treatment ◽  
Treatment Needs ◽  
Co Morbidity ◽  
The Us ◽  
Axis I ◽  
Dsm Iv

BackgroundDimensional models of co-morbidity have the potential to improve the conceptualization of mental disorders in research and clinical work, yet little is known about how relatively uncommon disorders may fit with more common disorders. The present study estimated the meta-structure of psychopathology in the US general population focusing on the placement of five under-studied disorders sharing features of thought disorder: paranoid, schizoid, avoidant and schizotypal personality disorders, and manic episodes as well as bipolar disorder.MethodData were drawn from the National Epidemiologic Survey on Alcohol and Related Conditions, a face-to-face interview of 34 653 non-institutionalized adults in the US general population. The meta-structure of 16 DSM-IV Axis I and Axis II psychiatric disorders, as assessed by the Alcohol Use Disorder and Associated Disabilities Interview Schedule DSM-IV version (AUDADIS-IV), was examined using exploratory and confirmatory factor analysis.ResultsWe document an empirically derived thought disorder factor that is a subdomain of the internalizing dimension, characterized by schizoid, paranoid, schizotypal and avoidant personality disorders as well as manic episodes. Manic episodes exhibit notable associations with both the distress subdomain of the internalizing dimension as well as the thought disorder subdomain. The structure was replicated for bipolar disorder (I or II) in place of manic episodes.ConclusionsAs our understanding of psychopathological meta-structure expands, incorporation of disorders characterized by detachment and psychoticism grows increasingly important. Disorders characterized by detachment and psychoticism may be well conceptualized, organized and measured as a subdimension of the internalizing spectrum of disorders. Manic episodes and bipolar disorder exhibit substantial co-morbidity across both distress and thought disorder domains of the internalizing dimension. Clinically, these results underscore the potential utility of conceptualizing patient treatment needs using an approach targeting psychopathological systems underlying meta-structural classification rubrics.

Digging out insights and behavioral correlates of false and true femininity in borderline personality disorder patients attending four-step integrative model group psychotherapy

2016 ◽  
Vol 33 (S1) ◽  
pp. s232-s232 ◽  
Author(s):  
M. Abdelhameed ◽  
R. Mahfouz ◽  
A. Kamal ◽  
M. Taha
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Group Psychotherapy ◽  
Borderline Personality ◽  
Integrative Model ◽  
Model Group ◽  
Behavioral Correlates ◽  
Dsm Iv ◽  
Competing Interest ◽  
Age Range

IntroductionThe four-step integrative model of psychotherapy is concerned with individual's needs, wants, rights and decisions in that order. It may carry a promise for deep and changing vision for patients with borderline personality disorder (BPD).ObjectivesThe study of the illuminating and changing effect of dealing with BPD patients in view of their needs, wants, rights and decisions.AimsTo evaluate the effect of group work through the hierarchy of the four-step integrative model with BPD patients and to help them explore false and true elements of their femininity.MethodsForty-three female patients (age range: 19-37) diagnosed according to DSM-IV diagnostic criteria for BPD were enrolled in a dynamic psychotherapy group. Their progress was evaluated using Borderline evaluation of severity over time (BEST) and they wrote down detailed comments about their experience quarterly.ResultsResults of regular attendants for 2 years were included (35 = 81.4%). The results of BEST showed a significant reduction of BPD severity at the end of 1 and 2 years. During psychotherapy sessions and within their quarterly comments, patients expressed their change in terms of moving from a state of cunning, manipulation, aggression, arrogance, envy and rejection (as stemming from their false femininity) into wisdom, confrontation, patience, pride, healthy competition and containment respectively (as stemming from their true femininity).ConclusionsPatients with BPD may gain a better insight and genuine change as they realize what is false and what is true about their femininity in the context of attending four-step integrative model group psychotherapy.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Relationship between cognitive functioning and 6-month clinical and functional outcome in patients with first manic episode bipolar I disorder

2010 ◽  
Vol 41 (5) ◽  
pp. 971-982 ◽  
Author(s):  
I. J. Torres ◽  
C. M. DeFreitas ◽  
V. G. DeFreitas ◽  
D. J. Bond ◽  
M. Kunz ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Clinical Outcome ◽  
Cognitive Functioning ◽  
Functional Outcome ◽  
Verbal Learning ◽  
Manic Episode ◽  
Type I ◽  
Co Morbidity ◽  
Dsm Iv ◽  
The Impact

BackgroundAlthough cognitive deficits in bipolar disorder have been associated with diminished functional outcome, this relationship has been studied primarily through cross-sectional designs, and has not been studied in patients early in the course of illness. The purpose of this study was to evaluate the impact of cognitive functioning on longitudinal 6-month functional and clinical outcome in recently diagnosed clinically stable patients with bipolar disorder.MethodA total of 53 recently diagnosed patients with DSM-IV bipolar disorder type I were assessed within 3 months of their first manic episode using a neuropsychological battery measuring verbal/pre-morbid intellectual functioning, learning/memory, spatial/non-verbal reasoning, attention/processing speed and executive function. Functional outcome was assessed at baseline and 6 months using the Multidimensional Scale of Independent Functioning (MSIF) and DSM-IV Global Assessment of Functioning Scale (GAF). Clinical outcome was assessed with symptom ratings and by monitoring onset of new mood episodes.ResultsMemory, particularly verbal learning/memory, was robustly associated with 6-month functional outcome on the MSIF, even after partialling out the influence of mood symptoms and substance abuse co-morbidity. Depression ratings at 6 months, but not cognitive variables, were associated with 6-month GAF scores. Cognitive functioning was not associated with 6-month clinical outcome.ConclusionsMemory was associated with 6-month longitudinal functional but not clinical outcome in recently diagnosed patients with bipolar disorder. These data further support the distinction between clinical and functional outcome, and emphasize the need for identification of, and development of treatments for, cognitive impairments early in the course of bipolar disorder.

Aripiprazole once monthly outpatient experience

2017 ◽  
Vol 41 (S1) ◽  
pp. S760-S760
Author(s):  
P. Sánchez Páez ◽  
J.L. Gómez Cano ◽  
L. Sánchez Flores ◽  
R. González Lucas ◽  
P. Artieda Urrutia
Keyword(s):  
Previous Treatment ◽  
Term Treatment ◽  
Tolerability Profile ◽  
Patient Profile ◽  
Co Morbidity ◽  
Long Term Treatment ◽  
Competing Interest ◽  
One Year ◽  
Image Position

IntroductionAripiprazole once monthly (AOM) is one of the most recently introduced antipsychotics with a different mechanism of action, which seems to bring clinical and tolerability implications [1].ObjectivesWe describe the patient profile that may benefit from AOM treatment.MethodsThis is a single-centre, retrospective, one year follow-up study of 13 cases of ambulatory AOM use. We analyze clinical and functional evolution, and the tolerability profile of patients in a real clinical practice basis.ResultsMean age was 53.69; 53.8% were males and 46.2% females. The most frequent diagnosis was Schizophrenia and other chronic psychosis (69.3%). Only 7.7% had co-morbidity with substance use disorder (cocaine); 61.6% were on previous treatment with other injectable anti-psychotics; 84,6% of the sample received AOM as monotherapy. Reasons for switching to AOM are shown on Fig. 1. Events during switching are shown on Fig. 2. Outcomes with AOM long-term treatment were positive in 84.61% of cases and are shown on Fig. 3.ConclusionsSwitching to AOM could be considered as a good strategy to improve tolerability, functionality and ultimately adherence to treatment in patients in middle age of life with a chronic psychotic disorder [2].Fig. 1Reasons for switching.Fig. 2Events during switching.Fig. 3Outcomes with AOM.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Emotional Schemas: A New Cognitive Perspective for the Distinction Between Unipolar Depression and Bipolar Disorder

2017 ◽  
Vol 41 (S1) ◽  
pp. S243-S243 ◽  
Author(s):  
O. Onur
Keyword(s):  
Bipolar Disorder ◽  
Rating Scale ◽  
Depression Scale ◽  
Unipolar Depression ◽  
Group Differences ◽  
Young Mania ◽  
Exploratory Investigation ◽  
General Activation ◽  
Dsm Iv ◽  
Competing Interest

IntroductionClinicians need to make the differential diagnosis between unipolar depression and bipolar disorder to guide their treatment choices. Looking at the differences observed in the emotional schemas might help with this differentiation. This study is an exploratory investigation of schema theory's Leahy's emotional schemas among individuals diagnosed with bipolar disorder and unipolar depression.MethodsThree groups of subjects 56 unipolar depression in the remission period, 70 bipolar eutimic and 58 healthy controls were asked to fill out the Leahy Emotional Schema Scale (LESS). The clinicians diagnosed the participants according to the criteria of DSM-IV-TR with SCID-I, and rated the moods of the subjects with the Beck Depression Scale, and the Young Mania Rating Scale (YMRS). Statistical analyses were undertaken to identify the group differences on LESS.ResultsThe bipolar eutimic and unipolar depression patients’ scores on the LESS dimensions were significantly different from the healthy participants in the areas of control, consensus, acceptance of feelings, dissimilarity and simplistic view of emotions.ConclusionsThese results suggest that the metacognitive model of unipolar depression might be extrapolated for patients with bipolar disorder. Bipolar disorder may be associated with a general activation of the emotional schemas.Disclosure of interestThe author has not supplied his/her declaration of competing interest.

Temporal tumor as a cause of bipolar-like disorder?

2017 ◽  
Vol 41 (S1) ◽  
pp. S471-S471
Author(s):  
S. Domingues ◽  
M. Cotter ◽  
I. Amado ◽  
R. Massano
Keyword(s):  
Bipolar Disorder ◽  
Psychiatric Symptoms ◽  
Sudden Onset ◽  
Psychomotor Agitation ◽  
Temporal Epilepsy ◽  
Co Morbidity ◽  
History Of ◽  
Competing Interest ◽  
History Of Epilepsy ◽  
Clinical Records

IntroductionThe relationship between brain tumours, temporal epilepsy and psychiatric symptoms are historically known.ObjectivesTo report a case of mania in a patient with previous diagnosis of bipolar disorder, temporal tumour and temporal epilepsy.MethodsClinical records. Research on PubMed, using “lateral temporal epilepsy” or “brain tumour” and “mania”.ResultsA 52 years old man was conducted to the emergency department by the police. He was found with psychomotor agitation at the Sanctuary of Fátima. He was apparently hyperthimic with flight of ideas. He had a history of epilepsy and temporal tumour and two previous manic episodes. It was assumed as a maniac episode.During inpatient evaluation, patient had memory for the occurrence. He described a sudden onset on the day before, after drinking wine. He described delirant atmosphere, persecutory and mystic delusional beliefs “this is the third secret of Fátima being revealed”, followed by ecstasy and psychomotor agitation. Remission was obtained in one week on psychotropics. MRI documented the lesion. Electroencephalography performed one month later revealed “slow waves.”ConclusionsOrganic causes should be excluded before consider a psychiatric disorder. The hypothesis of epilepsy-related psychosis or mania and other effects of a temporal tumour should be considered in etiology. However, co morbidity with bipolar disorder cannot be excluded.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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