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.

The Duration of Undiagnosed Bipolar Disorder: Impact of Substance use Disorders co-morbidity

2017 ◽  
Vol 41 (S1) ◽  
pp. S132-S132
Author(s):  
S. Ben Mustapha ◽  
W. Homri ◽  
L. Jouini ◽  
R. Labbane
Keyword(s):  
Bipolar Disorder ◽  
Substance Use ◽  
Standard Deviation ◽  
Substance Use Disorders ◽  
Mood Stabilizer ◽  
Type I ◽  
Addictive Behaviour ◽  
Bipolar Disease ◽  
Co Morbidity ◽  
The Impact

AimsStudy the impact of substance use disorders (SUD) co-morbidity on the duration of undiagnosed bipolar disorder (DUBP).MethodsCase-control study during a period of six months from July 2015 to December 2015. One hundred euthymic patients with BD (type I, II or unspecified) were recruited in the department of psychiatry C Razi Hospital, during their follow-up. Two groups were individualized by the presence or not of a SUD co-morbidity. In our study DUBP was defined as the period between the first symptoms and the beginning of treatment by a mood stabilizer.ResultsThe beginning of addictive behaviour preceded the installation of bipolar disease in 32% of cases. Installation of bipolar disorder preceded the installation of addictive behaviour in 12% of cases. The beginning of addictive behaviour was concomitant with the installation of bipolar disease in 6% of cases. The average DUBP in the full sample was 4.80 years with a standard deviation of 8.04 and extremes ranging from 0.08 to 37.5.The average DUBP in patients with SUD co-morbidity was 5.91 years with a standard deviation of 8.16 and extremes ranging from 0.08 to 35, and 3.68 years with a standard deviation of 7.84 and extremes ranging from 0.08 to 37.5 in patients without SUD co-morbidity.ConclusionsAccording to studies over two thirds of patients with bipolar disorder received misdiagnoses before diagnosis of BD, and among the factors involved can report the presence of SUD co-morbidity. Hence, we should detect BD among patients with SUD.Disclosure of interestThe authors have not supplied their declaration of competing interest.

The impact of premenstrual dysphoric disorder among 92 bipolar patients

2010 ◽  
Vol 25 (8) ◽  
pp. 450-454 ◽  
Author(s):  
M. Fornaro ◽  
G. Perugi
Keyword(s):  
Rating Scale ◽  
Post Partum ◽  
Premenstrual Dysphoric Disorder ◽  
Clinical Variable ◽  
Type I ◽  
Co Morbidity ◽  
Axis I ◽  
Dsm Iv ◽  
Bipolar Patients ◽  
The Impact

AbstractObjectivesTo evaluate the impact of Diagnostic and Statistical Manual for Mental Disorders-Fourth Edition (DSM-IV)-defined premenstrual dysphoric disorder (PMDD) lifetime co-morbidity among 92 bipolar patients.MethodNinety-two women with a lifetime diagnosis of DSM-IV-defined Bipolar Disorder (BD) either type I or type II were consecutively enrolled to determine co-morbidity rates with PMDD and associated clinical features. Measures included the Structured Clinical Interview for the DSM-IV Axis I Disorders (SCID-I) and the Clinical Global Impression (CGI) rating scale.ResultsIn our sample, 25 (27.2%) patients reported a lifetime history of PMDD according to DSM-IV criteria (PMDD+). PMDD+ reported higher rates of Cyclothymia and BP-II than PMDD− (respectively 72% vs. 36% and 88% vs. 60%). On the contrary, the carbohydrate-craving feature was more represented among PMDD− than PMDD+ (25% vs. 4%). PMDD was also significantly associated with post-partum depression (36% vs. 15%), Obsessive-Compulsive (24% vs. 7.5%) and Body Dysmorphic Disorders (24% vs. 6%). Finally, PMDD+ reported higher total number of Axis I co-morbid disorders than PMDD−.ConclusionsIn our cohort of BD women, PMDD is a frequent co-morbid condition, in particular among patients with BD-II or Cyclothymia. Multiple co-morbidities also represent a clinical variable associated with PMDD. Further perspective studies are necessary to better define the relationships between PMDD and BD.

scholarly journals The functional impairment of different subtypes and occupational states in euthymic patients with bipolar disorder

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Xinyu Liu ◽  
Xiaojuan Ma ◽  
Wenchen Wang ◽  
Jian Zhang ◽  
Xia Sun ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Social Functioning ◽  
Rating Scale ◽  
Verbal Learning ◽  
Occupational Status ◽  
Learning Performance ◽  
Neurocognitive Functioning ◽  
Type I ◽  
Speed Of Processing ◽  
Occupational Functioning

Abstract Background The aim was to explore the associations between clinical symptoms, demographic variables, social and neurocognitive functioning in euthymic patients with bipolar disorder (BD) stratified by subgroups of DSM-IV BD (type I (BD-I) and type II (BD-II)) and occupational status (employed/unemployed), and to highlight the significance of occupational status when assessing social and neurocognitive functioning in euthymic BD patients. Methods A total of 81 euthymic BD patients were participated in the study. The severity of the depressive and manic/hypomanic symptoms was measured using the 17-item Hamilton Depression Rating Scale (HDRS-17) and the Young Mania Rating Scale (YMRS), respectively. Social functioning and neurocognitive functioning were evaluated by the Functioning Assessment Short Test (FAST) and neurocognitive measures, respectively. Results Employed BD patients displayed greater social functioning (autonomy, occupational functioning, interpersonal relationship domain) and better verbal learning performance and speed of processing than unemployed BD patients. The correlation between neurocognitive functioning and social functioning was stronger in the employed group than in the unemployed group. There were no significant differences in neurocognitive and social functioning between the BD-I and BD-II groups, and the correlation between neurocognitive functioning and social functioning was similar between the BD-I and BD-II groups. Conclusion Employed BD patients may present greater occupational functioning and interpersonal relationships, as well as better verbal learning performance and speed of processing.

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.

Bipolar Type I Disorder in Children

2020 ◽  
Vol 1 (1) ◽  
pp. 11-14
Author(s):  
Syaiful Fadilah ◽  
Fatimah Haniman
Keyword(s):  
Bipolar Disorder ◽  
Children And Adolescents ◽  
Severe Disease ◽  
Large Population ◽  
Type I ◽  
Disease Course ◽  
Clinical Area ◽  
Clinical Disorder ◽  
Bipolar Type ◽  
Dsm Iv

Bipolar disorder in children and adolescents is a clinical disorder that causes publicmental health problems that need attention. In the last decade, bipolar disorder in children andadolescents has become a trendy field, both in the clinical area and in research, especially interms of diagnosis, which is still controversial. The controversy that remains is whether it ispossible to diagnose bipolar disorder in prepubertal children. Based on the DSM-IV-TRdiagnostic criteria, the prevalence of the bipolar disorder in children scarce rare.Epidemiological studies report the lifetime prevalence of bipolar I and II disorders in lateadolescence is about 1 per cent. Various studies in a large population have shown aprevalence rate of 0.1% -2%. The onset of bipolar disorder in children and adolescents is oftenaccompanied by a more severe disease course, compared to bipolar disorder with onset inadulthood. This case report presents a case of bipolar 1 in children accompanied bycomprehensive management.

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.

The effect of psychiatric co-morbidity on cognitive functioning in a population-based sample of depressed young adults

2009 ◽  
Vol 40 (1) ◽  
pp. 29-39 ◽  
Author(s):  
A. E. Castaneda ◽  
M. Marttunen ◽  
J. Suvisaari ◽  
J. Perälä ◽  
S. I. Saarni ◽  
...  
Keyword(s):  
Young Adults ◽  
Executive Functioning ◽  
Cognitive Functioning ◽  
Cognitive Deficits ◽  
Verbal Memory ◽  
Verbal Learning ◽  
Population Based ◽  
Term Memory ◽  
Co Morbidity ◽  
History Of

BackgroundPsychiatric co-morbidity is often inadequately controlled for in studies on cognitive functioning in depression. Our recent study established no major deficits in cognition among young adults with a history of pure unipolar depression. The present study extends our previous work by examining the effects of psychiatric co-morbidity and other disorder characteristics on depression-related cognitive functioning.MethodPerformance in verbal and visual short-term memory, verbal long-term memory and learning, attention, processing speed, and executive functioning was compared between a population-based sample aged 21–35 years with a lifetime history of unipolar depressive disorders (n=126) and a random sample of healthy controls derived from the same population (n=71). Cognitive functioning was also compared between the subgroups of pure (n=69) and co-morbid (n=57) depression.ResultsThe subgroups of pure and co-morbid depression did not differ in any of the cognitive measures assessed. Only mildly compromised verbal learning was found among depressed young adults in total, but no other cognitive deficits occurred. Received treatment was associated with more impaired verbal memory and executive functioning, and younger age at first disorder onset with more impaired executive functioning.ConclusionsPsychiatric co-morbidity may not aggravate cognitive functioning among depressed young adults. Regardless of co-morbidity, treatment seeking is associated with cognitive deficits, suggesting that these deficits relate to more distress.

scholarly journals Understanding the Impact of Bipolar Disorder Experience from an Insiders' Perspective

2020 ◽  
pp. 1-5
Author(s):  
Sophie Favre ◽  
Hélène Richard-Lepouriel ◽  
Sophie Favre
Keyword(s):  
Bipolar Disorder ◽  
Clinical Practice ◽  
Lived Experience ◽  
Life Experience ◽  
Single Case ◽  
Real Life ◽  
Future Research ◽  
Type I ◽  
Key Informant ◽  
The Impact

Introduction: Bipolar disorder is characterized by recurrent episodes of depression and hypomania and is often associated with functional impairment even between mood episodes. A substantial proportion of patients experience inter-episode mood swings, making bipolar disorder a complex psychiatric disorder to manage. Patients’ perspectives can enhance clinical practice and research. The present study aimed to explore the impact of the bipolar disorder experience from a patient’s perspective to facilitate better understanding in clinical practice and future research. Method: We conducted a single case study with a key informant living with bipolar disorder (type I) for more than 20 years. The key informant constructed a chart of his mood disorder experiences. Subsequently, he commented on the chart and these comments were noted down by his therapist. Results: We present a chart of lived experience perception by a person living with bipolar disorder. The main axis was reality perception and it was related with mood, identity, and functioning. The comments on the chart provided a detailed and accurate description of a lived experience of functioning of bipolar disorder and its impact on a person’s life. Discussion: Globally, the experiences described by the key informant are consistent with previous literature. The principal finding was the meaning of the subjective experiences of reality perception, their relation with mood change, and impact on the person’s life. The perception of reality seems to be a key factor in the experience of bipolar mood swings. Not only did the disorder affect the self and the functioning, but at its extreme, reality “either did not matter or did not exist.” This feeling enhanced the sense of being disconnected from the world and the surroundings and led to the experience of extreme loneliness. Conclusion: The description in this study cannot be generalized, since it was conducted with only one subject. However, it provided a better insight into the detailed real-life experience that can be useful for clinicians treating persons living with bipolar disorder. Such descriptions obtained from a qualitative procedure can also be combined with quantitative data in patients' assessments and research. This study suggests that the experience of “disconnection” should be investigated further.

The Functional Impairment of Different Subtypes and Occupational States in Euthymic Patients With Bipolar Disorder

2021 ◽  
Author(s):  
Xinyu Liu ◽  
Xiaojuan Ma ◽  
Wenchen wang ◽  
Jian Zhang ◽  
Xia Sun ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Social Functioning ◽  
Rating Scale ◽  
Verbal Learning ◽  
Occupational Status ◽  
Learning Performance ◽  
Neurocognitive Functioning ◽  
Type I ◽  
Speed Of Processing ◽  
Occupational Functioning

Abstract Background The aim was to explore the associations between clinical symptoms, demographic variables, social and neurocognitive functioning in euthymic patients with bipolar disorder (BD) stratified by subgroups of DSM-IV BD (BD-type I and BD-type II) and occupational status(employed/unemployed), and to highlight the significance of occupational status when assessing social and neurocognitive functioning in euthymic BD patients. Methods A total of 81 euthymic BD patients were participated in the study. The severity of the depressive and manic/hypomanic symptoms was measured using the 17-item Hamilton Depression Rating Scale (HDRS-17) and the Young Mania Rating Scale (YMRS), respectively. Social functioning and neurocognitive functioning were evaluated by the Functioning Assessment Short Test (FAST) and neurocognitive measures, respectively. Results Employed BD patients displayed greater social functioning (autonomy, occupational functioning, interpersonal relationship domain) and better verbal learning performance and speed of processing than unemployed BD patients. The correlation between neurocognitive functioning and social functioning was stronger in the employed group than in the unemployed group. There were no significant differences in neurocognitive and social functioning between the BD-I and BD-II groups, and the correlation between neurocognitive functioning and social functioning was similar between the BD-I and BD-II groups. Conclusion Employed BD patients may present greater occupational functioning and interpersonal relationships, as well as better verbal learning performance and speed of processing.

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