Clinical Factors as Predictors on Functional Impairment in Bipolar Disorder

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
A. Rosa ◽  
M. Reinares ◽  
C. Franco ◽  
M. Comes ◽  
C. Torrent ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Depressive Symptoms ◽  
Interpersonal Relationships ◽  
Functional Impairment ◽  
Severe Illness ◽  
Clinical Factors ◽  
Short Test ◽  
Dsm Iv ◽  
Bipolar Patients ◽  
Financial Issues

Introduction:Recent studies have suggested that functional impairment in bipolar disorder may be strongly associated with residual depressive symptoms. However, there is a notable disparity between functional recovery and symptomatic recovery. This study was carried out to investigate clinical factors as potential predictors on functional impairment in a well defined euthymic bipolar sample.Methods:Seventy-one patients were recruited from the Bipolar Disorder Program at the Clinic Hospital of Barcelona. A Structured Clinical Interview for DSM-IV-TR, HAM-D and YMRS were used to diagnostic assessment and euthymia criteria. The Functioning Assessment Short Test (FAST) was employed to assess functional impairment. The FAST is a reliable and valid, interview-administered scale, rapid and easy to apply (3-6 min). It consists of 24 items which allow to assess six specific areas of functioning such as autonomy, occupational functioning, cognitive functioning, financial issues, interpersonal relationships, and leisure time.Results:The sample comprised 36 (51%) men, aged 48±13.56 years. Several clinical variables were associated with poor functioning on a linear regression model, such as age, depressive symptoms, number of previous mixed episodes and number of previous hospitalizations. This model explained 44% of the variance (F=12.54, df=58, p< 0.001).Discussion:In this study, specific clinical and socio-demographic characteristics were identified as predictors of functional impairment in remitted bipolar patients. Poor functioning was identified in patients with older age and more severe illness course.

Functional impairment and previous suicide attempts in bipolar disorder

2008 ◽  
Vol 20 (6) ◽  
pp. 300-306 ◽  
Author(s):  
Adriane R. Rosa ◽  
Carolina Franco ◽  
Anabel Martínez-Aran ◽  
Jose Sánchez-Moreno ◽  
Manel Salamero ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Family History ◽  
Functional Impairment ◽  
Degrees Of Freedom ◽  
Suicide Attempts ◽  
Structured Interview ◽  
Psychotic Symptoms ◽  
History Of ◽  
Dsm Iv ◽  
Bipolar Patients

Objective:The aim of the present study was to assess the association between previous suicide attempts and functional impairment among euthymic patients with bipolar disorder (BD).Methods:Seventy-one Diagnostic Statistical Manual IV (DSM-IV) patients with BD and 61 healthy volunteers were recruited from the Bipolar Disorder Program at the Clinic Hospital of Barcelona. Patients with (n = 36, 50.7%) and without (n = 35, 49.3%) previous suicide attempts were assessed using the Structured Clinical Interview for DSM-IV-TR (SCID-P). Previous suicide attempts were carefully investigated by means of patient and caregiver interview and by a standard structured interview from the protocol of our BD Program. The Functioning Assessment Short Test (FAST) was employed to assess functional impairment.Results:Euthymic patients with previous suicide attempts showed functional impairment, particularly in occupational (F = 30.39; p = 0.001) and cognitive functioning (F = 18.43; p = 0.001). In addition, family history of psychiatric illness (χ2: 6.49; degrees of freedom (df) = 2;132; p = 0.010), family history of affective disorders (χ2 = 5.57; p = 0.017), psychotic symptoms (χ2 = 5.88; p = 0.014) and axis II comorbidity were associated with previous suicide attempts (χ2 = 5.16; p = 0.021).Conclusion:Bipolar patients with previous suicide attempts had lower overall functioning than patients who did not attempt suicide. Previous suicide attempts were particularly associated with the occupational and cognitive domains of functioning.

Psychosocial functioning impairment in euthymic patients with bipolar disorder II: The role of clinical factors

2016 ◽  
Vol 33 (S1) ◽  
pp. S333-S333
Author(s):  
R.S. Ilhan ◽  
V. Senturk-Cankorur
Keyword(s):  
Bipolar Disorder ◽  
Psychosocial Functioning ◽  
Rating Scale ◽  
Healthy Individuals ◽  
Young Mania ◽  
Clinical Variables ◽  
Hamilton Anxiety Rating Scale ◽  
Short Test ◽  
Competing Interest ◽  
Bipolar Patients

IntroductionGrowing body of evidence have showed that euthymic bipolar patients have poor psychosocial functioning. Most of the studies have focused on the psychosocial functioning in euthymic bipolar disorder (BD)-I patients. On the contrary, there have been limited researches investigating psychosocial functioning in euthymic BD-II patients. Moreover, the factors associated with psychosocial functioning in euthymic patients with BD II have been also understudied.Objectives/aimsAim of our study was to investigate the association between clinical variables and poor psychosocial functioning in euthymic BD-II patients. Hypothesis of this study was that euthymic BD-II patients would have low level of psychosocial functioning compared with healthy individuals.MethodsBD-II (n = 37) and healthy subjects (n = 35) were compared in terms of their psychosocial functioning which were assessed by Functional Assessment Short Test (FAST). The euthymic state was confirmed by low scores both on the Hamilton Depression Rating Scale (HDRS) and the Young Mania Rating Scale (YMRS). Anxiety symptoms were also assessed by Hamilton Anxiety Rating Scale (HARS) in both groups. Clinical variables were taken as independent variables and FAST scores were taken as dependent variable in order to run correlation analysis in BD-II group.ResultsNo socio-demographic differences were found between two groups. Euthymic BD-II patients had significantly higher FAST, HARS, HDRS YMRS scores compared with healthy individuals. Only HDRS scores correlated with FAST scores of BD-II patients.ConclusionsThis study indicated that euthymic BD-II patients had poorer psychosocial functioning. And subclinical depressive symptoms were associated with poor psychosocial functioning.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Perceived stigma and depression among caregivers of patients with bipolar disorder

2007 ◽  
Vol 190 (6) ◽  
pp. 535-536 ◽  
Author(s):  
Deborah A. Perlick ◽  
David J. Miklowitz ◽  
Bruce G. Link ◽  
Elmer Struening ◽  
Richard Kaczynski ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Depressive Symptoms ◽  
Perceived Stigma ◽  
Patient Status ◽  
Coping Effectiveness ◽  
Clinical And Functional Status ◽  
Dsm Iv ◽  
Socio Demographic Factors ◽  
And Coping ◽  
The Relationship

SummaryThis study investigates the associations between perceived stigma, depressive symptoms and coping among caregivers of people with bipolar disorder. Caregivers of 500 people with DSM–IV bipolar disorder responded to measures of these constructs at study entry Patients' clinical and functional status were evaluated within 30 days of the caregiver assessment. Perceived stigma was positively associated with caregiver depressive symptoms, controlling for patient status and socio-demographic factors. Social support and avoidance coping accounted for 63% of the relationship between caregiver stigma and depression. Results suggest that caregivers' perceptions of stigma may negatively affect their mental health by reducing their coping effectiveness.

Dimensions of mania: differences between mixed and pure episodes

2004 ◽  
Vol 19 (5) ◽  
pp. 307-310 ◽  
Author(s):  
Ana González-Pinto ◽  
Ana Aldama ◽  
Asunción González Pinto ◽  
Fernando Mosquera ◽  
José Luis Pérez de Heredia ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Clinical Trials ◽  
Depressive Symptoms ◽  
Factorial Analysis ◽  
Mixed States ◽  
Varimax Rotation ◽  
Factor Solution ◽  
Bipolar I Disorder ◽  
Five Dimensions ◽  
Dsm Iv

AbstractObjectiveThe presence of at least five dimensions in mania has recently been established. This study extends previous findings by comparing the dimensions of pure vs. mixed mania.Materials and methodOne hundred and three inpatients with bipolar I disorder, manic or mixed (DSM IV), were assessed with SCID-I, YMRS and HDRS-21. The five-factor solution found after applying factorial analysis with Varimax rotation was compared between manic and mixed patients.ResultsThere were differences between pure mania and mixed states on factor 1 (depression) and factor 3 (hedonism). There was a tendency to present higher values on factor 5 (activation) in the pure manic group. No differences were found in factor 2 (dysphoria) and factor 4 (psychosis).DiscussionHedonism and activation dimensions are present to a lesser degree in mixed states. Although the principal difference between mixed and pure bipolar disorder is the existence of depressive symptoms, the depressive dimension is strongly present in patients with pure mania.ConclusionsThere is need to search for core depressive symptoms in all patients suffering from mania and to evaluate their outcome in clinical trials.

scholarly journals Electroconvulsive Therapy (ECT) in Bipolar Disorder Patients with Ultra-Rapid Cycling and Unstable Mixed States

Medicina ◽  
2021 ◽  
Vol 57 (6) ◽  
pp. 624
Author(s):  
Sergey Mosolov ◽  
Christoph Born ◽  
Heinz Grunze
Keyword(s):  
Bipolar Disorder ◽  
Depressive Symptoms ◽  
Electroconvulsive Therapy ◽  
Mood Stabilizer ◽  
Rapid Cycling ◽  
Mixed States ◽  
Limited Effectiveness ◽  
Bipolar Patients ◽  
Depressive Episodes

Background and Objectives: Unstable mixed episodes or rapid switching between opposite affective poles within the scope of short cycles was first characterized in 1967 by S. Mentzos as complex polymorphous states with chaotic overlap of manic and depressive symptoms. Well-known examples include antidepressant-induced mania/hypomania and rapid/ultra-rapid/ultradian cycling, when clinicians observe an almost continuous mixed state with a constant change of preponderance of manic or depressive symptoms. Achieving stable remission in these cases is challenging with almost no data on evidence-based treatment. When mood stabilizers are ineffective, electroconvulsive therapy (ECT) has been suggested. Objectives: After reviewing the evidence from available literature, this article presents our own clinical experience of ECT efficacy and tolerability in patients with ultra-rapid cycling bipolar disorder (BD) and unstable mixed states. Materials and Methods: We conducted an open, one-year observational prospective study with a “mirror image” design, including 30 patients with rapid and ultra-rapid cycling BD on long-term mood stabilizer treatment (18 received lithium carbonate, 6 on valproate and 6 on carbamazepine) with limited effectiveness. A bilateral ECT course (5–10 sessions) was prescribed for regaining mood stability. Results: ECT was very effective in 12 patients (40%) with a history of ineffective mood stabilizer treatment who achieved and maintained remission; all of them received lithium except for 1 patient who received carbamazepine and 2 with valproate. Nine patients (30%) showed partial response (one on carbamazepine and two on valproate) and nine patients (30%) had no improvement at all (four on carbamazepine and two on valproate). For the whole sample, the duration of affective episodes was significantly reduced from 36.05 ± 4.32 weeks in the year prior to ECT to 21.74 ± 12.14 weeks in the year post-ECT (p < 0.001). Depressive episodes with mixed and/or catatonic features according to DSM-5 specifiers were associated with a better acute ECT response and/or long-term mood stabilizer treatment outcome after ECT. Conclusions: ECT could be considered as a useful option for getting mood instability under control in rapid and ultra-rapid cycling bipolar patients. Further randomized trials are needed to confirm these results.

scholarly journals Social-Cognitive Bias and Depressive Symptoms in Outpatients with Bipolar Disorder

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Guillermo Lahera ◽  
Adolfo Benito ◽  
Ana González-Barroso ◽  
Rocío Guardiola ◽  
Sara Herrera ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Depressive Symptoms ◽  
Social Cognition ◽  
Functional Outcome ◽  
Cognitive Bias ◽  
Social Cognitive ◽  
Matched Control ◽  
Statistical Significance ◽  
Global Functioning ◽  
Bipolar Patients

A deficit of social cognition in bipolar disorder has been shown, even when patients are stable. This study compares the attribution of intentions (social-cognitive bias) in a group of 37 outpatients with bipolar disorder with 32 matched control subjects. Bipolar patients scored significantly higher in the Ambiguous Intentions Hostility Questionnaire, showing an angry and intentionality bias (P=.001,P=.02). Differences in blame scale and hostility bias did not reach statistical significance, but a trend was found (P=.06). Bipolar patients with depressive symptoms presented a higher score in the angry bias scale (P=.03) and aggressivity bias scale (P=.004). The global functioning (GAF) correlates significantly with intentionality (P=.005), angry (P=.027), and aggressivity (P=.020) biases. Bipolar patients show a social-cognitive bias that may play a role in their functional outcome.

Subsyndromal Depressive Symptoms Are Associated With Functional Impairment in Patients With Bipolar Disorder

2006 ◽  
Vol 67 (10) ◽  
pp. 1551-1560 ◽  
Author(s):  
Lori L. Altshuler ◽  
Robert M. Post ◽  
David O. Black ◽  
Paul E. Keck ◽  
Willem A. Nolen ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Depressive Symptoms ◽  
Functional Impairment

P01-201-Polarity of most recent affective episode and other clinical factors in relation to quality of life in remitted bipolar patients

2011 ◽  
Vol 26 (S2) ◽  
pp. 202-202
Author(s):  
T. Novak ◽  
L. Sprah ◽  
M. Dernovsek
Keyword(s):  
Quality Of Life ◽  
Bipolar Disorder ◽  
Depressive Episode ◽  
World Health ◽  
Clinical Factors ◽  
World Health Organization Quality ◽  
Outpatient Group ◽  
Bipolar Patients ◽  
Depressive Episodes

IntroductionQuality of life (QoL) is reported to be markedly impaired even in interepisode bipolar disorder. Recent depressive episode correlates with poorer QoL than recent manic episode in remitted patients.AimsWe compared QoL between bipolar patients with regard to the polarity of most recent episodes and control group in order to assess relationships between clinical factors and quality of life in bipolar outpatients.Methods33 remitted bipolar outpatients (19 depressive and 14 manic according to the polarity of recent episode), and 22 healthy individuals completed the World Health Organization Quality of Life Instrument-Short Version (WHOQOL-BREF).ResultsOutpatients with recent depressive episode reported the lowest overall QoL and health satisfaction and had the lowest scores on psychological domain among all groups. Polarity of most recent episode didn’t correlate significantly with QoL. In outpatient group as a whole, several clinical factors including previous depressive episodes were significantly correlated with WHOQOL-BREF scores.ConclusionsQoL is impaired in remitted bipolar outpatients. Despite the insignificant association between polarity of most recent episode and QoL, our data confirm that depressive symptoms are among the most significant contributors to reduced QoL in bipolar disorder. The importance of gaining full remission is associated with improved QoL.

Suicidal Attempts Among Bipolar Patients: Correlation with Affective Temperaments and Life Events

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
G. Amara ◽  
N. Ben Salah ◽  
S. Ben Nasr ◽  
B. Ben Hadj Ali
Keyword(s):  
Bipolar Disorder ◽  
Life Events ◽  
Negative Impact ◽  
Bipolar Ii Disorder ◽  
Affective Temperaments ◽  
Bipolar Ii ◽  
Suicidal Attempts ◽  
Affective Temperament ◽  
Dsm Iv ◽  
Bipolar Patients

Aims:In this study, we focused on the correlations between life events, affective temperaments and suicidal attempts among patients with bipolar disorder.Methods:Patients with DSM IV diagnosis of bipolar I or bipolar II disorders were recruited from psychiatric consultation of the Farhat Hached Hospital in Sousse. All bipolar patients were in remission for at least four weeks. Suicidal attempts were checked by interrogating patients and consulting medical observations. Affective temperament dimensions were determined by using the Arabic version of TEMPS-A. The assessment of life events was based on the Paykel scale.Results:A total of 57 patients (47 with bipolar I disorder and 10 with bipolar II disorder) have participated in the study, with a mean age of 41,8 ± 11,3 years and a gender ratio of 2,29. Suicidal attempt number was positively correlated with depressive (p=0,021) and anxious (p=0,015) temperament, early orphanage (p=0,008) and the total number of life events (p=0,011). It was also correlated with the global negative impact of these events (p=0,036).Conclusion:According to our findings, life events and their negative impact, early parental loss and anxious and depressive temperaments predispose to suicidal attempts among patients with bipolar disorder. Further prospective studies are required to confirm these results.

Sign in / Sign up

Export Citation Format

Share Document