The characteristics of psychotic features in bipolar disorder

2018 ◽  
Vol 49 (12) ◽  
pp. 2036-2048 ◽  
Author(s):  
Annet H. van Bergen ◽  
Sanne Verkooijen ◽  
Annabel Vreeker ◽  
Lucija Abramovic ◽  
Manon H. Hillegers ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Childhood Maltreatment ◽  
Linear Models ◽  
Disease Onset ◽  
Cross Sectional Study ◽  
Psychotic Symptoms ◽  
Type I ◽  
Cross Sectional ◽  
History Of ◽  
Psychotic Features

AbstractBackgroundIn a large and comprehensively assessed sample of patients with bipolar disorder type I (BDI), we investigated the prevalence of psychotic features and their relationship with life course, demographic, clinical, and cognitive characteristics. We hypothesized that groups of psychotic symptoms (Schneiderian, mood incongruent, thought disorder, delusions, and hallucinations) have distinct relations to risk factors.MethodsIn a cross-sectional study of 1342 BDI patients, comprehensive demographical and clinical characteristics were assessed using the Structured Clinical Interview for DSM-IV (SCID-I) interview. In addition, levels of childhood maltreatment and intelligence quotient (IQ) were assessed. The relationships between these characteristics and psychotic symptoms were analyzed using multiple general linear models.ResultsA lifetime history of psychotic symptoms was present in 73.8% of BDI patients and included delusions in 68.9% of patients and hallucinations in 42.6%. Patients with psychotic symptoms showed a significant younger age of disease onset (β = −0.09, t = −3.38, p = 0.001) and a higher number of hospitalizations for manic episodes (F11 338 = 56.53, p < 0.001). Total IQ was comparable between groups. Patients with hallucinations had significant higher levels of childhood maltreatment (β = 0.09, t = 3.04, p = 0.002).ConclusionsIn this large cohort of BDI patients, the vast majority of patients had experienced psychotic symptoms. Psychotic symptoms in BDI were associated with an earlier disease onset and more frequent hospitalizations particularly for manic episodes. The study emphasizes the strength of the relation between childhood maltreatment and hallucinations but did not identify distinct subgroups based on psychotic features and instead reported of a large heterogeneity of psychotic symptoms in BD.

Risk of bipolar disorder and psychotic features in patients initially hospitalised with severe depression

2014 ◽  
Vol 27 (2) ◽  
pp. 113-118 ◽  
Author(s):  
Kimiya Nakamura ◽  
Junichi Iga ◽  
Naoki Matsumoto ◽  
Tetsuro Ohmori
Keyword(s):  
Bipolar Disorder ◽  
Severe Depression ◽  
Psychotic Symptoms ◽  
Primary Disorder ◽  
Icd 10 ◽  
History Of ◽  
Physical Diseases ◽  
The Stability ◽  
Psychotic Features ◽  
Depressive Episodes

ObjectiveSevere depression may be a risk factor for diagnostic conversion into bipolar disorder (BD), and psychotic depression (PD) has been consistently associated with BD. The aims of the present study were to investigate the stability of the diagnosis of severe depression and the differences between PD and non-psychotic severe depression (non-PD), as well as to assess the effectiveness of electroconvulsive therapy (ECT).MethodsPatients who were hospitalised for severe depression (diagnosed according to ICD-10) both with and without psychotic symptoms (n=89; mean age=55.6 years, SD=13.9) from 2001 to 2010 were retrospectively assessed.ResultsBy the 75th month of follow-up assessments, 11(12.4%) patients had developed BD. Among these 11 converters, nine had developed BD within 1 year after admission. Only sub-threshold hypomanic symptoms were significantly related to developing BD. The number of depressive episodes and history of physical diseases were significantly increased in non-PD compared with PD patients, whereas ECT was significantly increased in PD compared with non-PD patients. There was a significant association between length of stay at the hospital and the number of days between admission and ECT.ConclusionSub-threshold hypomanic symptoms may represent a prodrome of BD or an indicator of an already manifest phenotype, especially in older patients, which suggests cautious use of antidepressants. In severe depression, non-PD may often occur secondary to physical diseases and patients may experience increased recurrences compared with PD patients, which may be a more ‘primary’ disorder and often requires ECT treatments. ECT is effective for severe depression regardless of the presence of any psychotic feature; the earlier ECT is introduced, the better the expected treatment outcome.

Bipolar Disorder and Cannabis

2017 ◽  
Vol 41 (S1) ◽  
pp. S118-S119
Author(s):  
G. Jmii ◽  
M. Zghal ◽  
F. Ghali ◽  
M. Mezghenni ◽  
L. Jouini ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Substance Dependence ◽  
Suicide Attempts ◽  
Bipolar Disorders ◽  
Cross Sectional Study ◽  
Cannabis Use ◽  
Type I ◽  
Cross Sectional ◽  
Average Hospital ◽  
Bipolar Patients

IntroductionPeople with bipolar disorder frequently struggle with substance abuse and dependence. Typically, cannabis is the most commonly abused drug in individuals with bipolar disorder. Some investigators have implied that cannabis may actually be mood stabilizing in patients with bipolar disorder. However, the relationships between cannabis use and bipolar disorders are complex and remain incompletely described.ObjectiveThe aim of this study was to identify the characteristics of addiction to cannabis in bipolar patients type I and determine the consequences of cannabis on the expression of bipolar illness and prognosis.MethodsThis is a comparative cross-sectional study which included patients followed in the psychiatry department of the G Razi hospital for bipolar disorder type I and for substance dependence according to DSM IV diagnostic criteria. Hetero-questionnaire on sociodemographic variables, clinical and treatment.ResultsThe average age was 41 years. The average hospital stay was 9.18 days. 33.33% of patients were monitored regularly. Most patients were single and worked as a day labourer. Cannabis was the most consumed substance. Cannabis use was prior to the expression of psychiatric illness in 55% of cases. The average number of hospitalisation in patients with a cannabis addiction was significantly greater than that observed in the non-addicted group. Similarly, the average number of suicide attempts among patients with cannabis addiction was significantly higher than the group without cannabis addiction.ConclusionsAggressive drug abuse treatment immediately after a first psychiatric hospitalisation might decrease rates of recurrence and new cases of cannabis use disorder in the course of bipolar disorder.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals The prevalence of cross-reactivity of cephalosporin in penicillin-allergic patients: A cross-sectional study in Thailand

2018 ◽  
Vol 26 (3) ◽  
pp. 151-155
Author(s):  
Panadda Aiyaka ◽  
Win Techakehakij
Keyword(s):  
Clinical Decision Making ◽  
Asian Population ◽  
Clinical Decision ◽  
Cross Sectional Study ◽  
Cross Reactivity ◽  
Type I ◽  
Cross Sectional ◽  
First Choice ◽  
History Of

Background: Cross-reactivity between penicillin and cephalosporin is of crucial concern among patients who have had a previous allergic reaction to penicillin, and cephalosporin is the first choice for their diseases. There is very little evidence concerning the prevalence of cross-reactivity in the Asian population. Objectives: This study aims to explore the cross-reactivity between penicillin and cephalosporin in the Asian population. Methods: This study included patients who were registered at Lampang Hospital from January 2011 to January 2018. Only patients who were prescribed penicillins and cephalosporins at least once as recorded in the electronic medical records (EMR), were included. Patients having penicillin and cephalosporin allergies were defined as those who were diagnosed in the EMR as allergic to drugs in the penicillin/ cephalosporin groups, in either the probable or definite categories with respect to the Naranjo’s algorithm. Cross-reactivity is defined as patients who were diagnosed as being allergic to both penicillin and cephalosporin. Data about characteristics and types of allergic reactions (type I & IV) were obtained from the EMR. Results: A total of 13,959 patients were included in the study. Of these, 99 penicillin-allergic and 13,860 non-penicillin-allergic patients were identified. The prevalence of cross-reactivity among patients with a history of penicillin allergy was 8.1%. Results showed high cross-reactivity rates among patients with type 1 (16.7%) and type 4 (13.3%) hypersensitivity, in relation to other allergic manifestations (3.4%). Conclusions: This study raises the possibility that cross-reactivity reported in previous research may differ from that in the Asian population. More Asian-based studies are needed to evaluate this cross-reaction so that this information can further assist medical professionals in clinical decision-making.

scholarly journals The impact of a history of psychotic symptoms on cognitive function in euthymic bipolar patients: a comparison with schizophrenic patients and healthy controls

2011 ◽  
Vol 33 (4) ◽  
pp. 353-361 ◽  
Author(s):  
Sofia Brissos ◽  
Vasco Videira Dias ◽  
Márcio Gerhardt Soeiro-de-Souza ◽  
Vicent Balanzá-Martínez ◽  
Flavio Kapczinski
Keyword(s):  
Negative Symptoms ◽  
Cross Sectional Study ◽  
Psychotic Symptoms ◽  
Neurocognitive Performance ◽  
Cross Sectional ◽  
Neurocognitive Dysfunction ◽  
Schizophrenic Patients ◽  
History Of ◽  
Bipolar Patients ◽  
The Impact

BACKGROUND: About two-thirds of patients with bipolar disorder (BD) have a lifetime history of at least one psychotic symptom. Objective: To compare the neurocognitive performance of four groups: BD patients with and without a history of psychotic symptoms (BD HPS+ and BD HPS-, respectively); patients with schizophrenia (SZ); and healthy control (HC) subjects. METHOD: In this cross-sectional study, 35 stabilized patients with SZ, 79 euthymic (44 HPS+ and 35 HPS-) patients with BD, and 50 HC were administered a comprehensive battery of neuropsychological tests. RESULTS: There was worse neurocognitive functioning in both BD and SZ patients compared to HC. Overall, data from both groups of BD patients did not differ on sociodemographic, clinical, or neurocognitive variables. However, BD HPS+ patients had significantly more negative symptoms, as measured by the Positive and Negative Syndrome Scale (PANSS), and showed a trend toward worse performance on executive functions compared to BD HPS- patients. Moreover, both BD groups had better performance on all neurocognitive tests compared to SZ group. CONCLUSIONS: Neurocognitive dysfunction may be more marked in SZ than in BD, yet qualitatively similar. A history of past psychotic symptoms in BD was not associated with more severe cognitive impairment during euthymia. Therefore, BD with psychotic symptoms does not appear to be a distinct neurocognitive phenotype.

Addiction co-morbidity in bipolar disorder

2017 ◽  
Vol 41 (S1) ◽  
pp. S312-S312
Author(s):  
A. Baatout ◽  
U. Ouali ◽  
R. Jomli ◽  
H. Elkefi ◽  
A. Oumaya ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Type I ◽  
Cross Sectional ◽  
Illness Onset ◽  
Co Morbidity ◽  
The Mean ◽  
Competing Interest ◽  
Long Acting ◽  
Psychotic Features ◽  
To Receive

IntroductionAddiction is often underdiagnosed in bipolar disorder (BD), although it is frequent and known to complicate its clinical course.ObjectivesThe aim of our study was to study socio-demographic and clinical factors associated with addiction in BD patients.MethodsThis is a retrospective, cross-sectional, descriptive and comparative study on 100 patients followed in our department and diagnosed with BD type I according to DSM 5. Demographic and clinical data was compared across the groups: Addiction + (A + ) and Addiction–(A − ).ResultsNighteen patients had an addiction co-morbidity (A + ), whereas 81 had not (A − ). The mean age of the (A + ) group was 39.47 years whereas it was 42.52 years in the (A − ) group. Males represented 68.4% of the (A + ) group and 48.1% of the (A − ) group. Age of illness onset was lower in the (A + ) group (mean = 23.16, median = 21) compared to the (A − ) group (mean = 26.04, median = 27). Addiction co-morbidity was significantly associated with predominant manic polarity (P = 0.03). All (A + ) patients presented mood episodes with psychotic features, whereas psychotic features were only found in 86.6% of (A − ) patients. Co-morbid addiction was significantly associated with a higher number of mood episodes (P = 0.04), a higher number and duration of hospitalisations (P = 0.02, P = 0.015), and a poorer compliance (P = 0.07). All A+ subjects received antipsychotics, and they were significantly more to receive long-acting antipsychotics (P = 0.06).ConclusionsAddictions worsen the prognosis of bipolar disorder and require specific therapeutic strategies. They deserve therefore the particular attention of clinicians.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Clinical Characteristics and Burden of a Large Series with Cluster Headache From Turkey: A Cross-Sectional Study From Headache Centers

2021 ◽  
Author(s):  
PINAR YALINAY DIKMEN ◽  
CAGLA ARI ◽  
ERDI SAHIN ◽  
MUSTAFA ERTAS ◽  
FUSUN MAYDA DOMAC ◽  
...  
Keyword(s):  
Cluster Headache ◽  
Clinical Characteristics ◽  
Past History ◽  
Positive Family History ◽  
Disease Onset ◽  
Diagnostic Delay ◽  
Preventive Treatment ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
History Of

Abstract Background: Our purpose was to investigate the demographics, diagnosis patterns, clinical characteristics, triggers, treatment experiences, and personal burden of patients with Cluster headache (CH) in Turkey, a country located between Europe and Asia.Methods: The study is a cross-sectional investigation based on data from eight headache centers in Turkey. All patients completed the semi-structured survey either face to face or by phone interview with a neurologist.Results: A total of 209 individuals with a mean age of 39.8 (11.3) completed the survey (176 males; 188 episodic, 21 chronic). The mean age at disease onset was 28.6 (10.2) years. The diagnostic delay was 4.9 years and misdiagnosis before CH was 57.9%. Of participants, 9.1% reported a positive family history for CH. Male patients with CH showed higher rates for being current smokers in comparison to females (59.7% vs. 24.2%; p<0.0001) and they also had significantly more past history of smoking at the time of first diagnosis (60.8% vs. 21.2%; p<0.0001). Females with CH had a previous diagnosis of migraine more frequently (57.6% vs. 27.3; p=0.001). Attack duration without treatment was significantly longer in female patients with CH compared to males (112 min vs. 87 min; p=0.029). Female participants had more migrainous features (57.6 % vs. 36.9%; p=0.033) and nausea/vomiting (48.5% vs. 30.1%; p=0.045) during their attacks. Only 42.1% of all participants reported satisfying treatment experiences. Of the participants, 85.9 % reported that oxygen was efficient for abortive treatment of CH; however, only 22 % of them had an oxygen tube at home. Female participants, as well as chronic CH patients, reported a higher likelihood of preventive treatment experiences. In this study, 49.3% of all participants appeared to be disabled by their headaches. Over one-quarter percent of our cohort reported that CH caused job-related burden.Conclusion: Remarkable diagnostic delay is an ongoing problem for CH and migraine was the most common misdiagnosis. Nearly half of the patients suffered from a burden of CH regardless of chronicity. Both past abortive and preventive treatment experiences of the participants highlight the insufficient efficacy of available choices and the necessity of more specific treatments for CH.

scholarly journals Predictors for Depression, Sleep Disturbance, and Subjective Pain among Inpatients with Depressive Disorders during the COVID-19 Pandemic: A Cross-Sectional Study

2021 ◽  
Vol 18 (12) ◽  
pp. 6523
Author(s):  
Dian-Jeng Li ◽  
Su-Ting Hsu ◽  
Frank Huang-Chih Chou ◽  
Li-Shiu Chou ◽  
Kuan-Ying Hsieh ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Linear Regression ◽  
Sleep Disturbance ◽  
Psychological Trauma ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Drinking Alcohol ◽  
Cross Sectional ◽  
Subjective Pain ◽  
History Of

The coronavirus disease 2019 (COVID-19) pandemic can have a negative impact on patients with mood disorders. The aim of this study is to explore the societal influence of COVID-19 and associated impacts on levels of depression, sleep disturbance, and subjective pain among patients with mood disorders. This cross-sectional study recruited inpatients with depression and bipolar disorder. Levels of depression, sleep disturbance, subjective pain, and related demographic variables were collected through self-reported questionnaires. Potential factors associated with levels of depression, sleep disturbance, and subjective pain were identified using univariate linear regression and further entered into a stepwise multivariate linear regression model to identify the independent predictors. A total of 119 participants were included in the analysis, of whom 50.42% had bipolar disorder and 49.58% had unipolar depression. Multivariate analysis showed that a higher level of depression was associated with female subjects, subjects with partners, present history of psychological trauma, and drinking alcohol. Sleep disturbance was associated with subjects with partners and drinking alcohol. A higher level of subjective pain was associated with a higher level of social anxiety and a history of psychological trauma. The current study identified several predictors of psychological burden and subjective pain among inpatients with depression during the COVID-19 pandemic. Further investigations are warranted to extend the application and generalizability of our results.

scholarly journals Neuropsychological status of bipolar I disorder: impact of psychosis

2009 ◽  
Vol 194 (3) ◽  
pp. 243-251 ◽  
Author(s):  
Jonathan Savitz ◽  
Lize van der Merwe ◽  
Dan J. Stein ◽  
Mark Solms ◽  
Rajkumar Ramesar
Keyword(s):  
Bipolar Disorder ◽  
Personality Traits ◽  
Childhood Trauma ◽  
Declarative Memory ◽  
Type I ◽  
Schizotypal Personality ◽  
Neuropsychological Status ◽  
History Of ◽  
Psychotic Features ◽  
The Impact

BackgroundThe presence of schizotypal personality traits in some people with bipolar disorder, together with reports of greater cognitive dysfunction in patients with a history of psychotic features compared with patients without such a history, raises questions about the nosological relationship between bipolar disorder with psychotic features and bipolar disorder without psychotic features.AimsTo test the impact of a history of DSM–IV-defined psychosis on the neuropsychological status of participants with bipolar disorder while statistically controlling for confounding factors such as mood, medication, alcohol misuse/dependence and childhood abuse, and to evaluate the impact of schizotypal personality traits (and thus potential vulnerability to psychotic illness) on the cognitive performance of people with bipolar disorder and their healthy relatives.MethodNeuropsychological data were obtained for 25 participants with type I bipolar disorder and a history of psychosis, 24 with type I bipolar disorder but no history of psychosis and 61 unaffected relatives. Schizotypal traits were measured with the Schizotypal Personality Scale (STA). Childhood trauma was measured with the Childhood Trauma Questionnaire.ResultsThe group with a history of psychosis performed significantly worse than the healthy relatives on measures of verbal working memory, cognitive flexibility and declarative memory. Nevertheless, the two bipolar disorder groups did not differ significantly from each other on any cognitive measure. Scores on the STA were negatively associated with verbal working and declarative memory, but positively associated with visual recall memory.Conclusions‘Psychotic’ and ‘non-psychotic’ subtypes of bipolar disorder may lie on a nosological continuum that is most clearly defined by verbal memory impairment.

scholarly journals Suicide Behavior and Its Predictors in Patients with Schizophrenia in Ethiopia

2021 ◽  
Vol 2021 ◽  
pp. 1-10
Author(s):  
Mohammed Ayalew ◽  
Semira Defar ◽  
Yared Reta
Keyword(s):  
Suicidal Behavior ◽  
Statistical Significance ◽  
Binary Logistic Regression ◽  
Cross Sectional Study ◽  
Psychotic Symptoms ◽  
Early Screening ◽  
Cross Sectional ◽  
Suicide Behavior ◽  
History Of ◽  
Suicide Behaviors

Background. People with schizophrenia (PWS) are at greater risk of suicide. However, suicide behaviors that occur in PWS are often overlooked, inadequately characterized, and not consistently integrated into treatment. Despite this burden and consequences in Ethiopia, there is a dearth of studies concerning suicide behavior in PWS. Therefore, this study is aimed at assessing the magnitude of suicide behavior and its predictors among PWS in Ethiopia. Methods. An institution based cross-sectional study was employed. Data were collected using the structured interviewer-administered questionnaire from a sample of 300 PWS at Amanuel Mental Specialized Hospital (AMSH). The revised version of Suicide Behavior Questionnaire (SBQ-R) was used to assess suicide behavior in PWS. The data was collected from March 1 to 30, 2019. Binary logistic regression was performed to identify independent predictors of suicidal behavior at 95% confidence level. Statistical significance was declared at p value <0.05. Result. A total of 300 patients with schizophrenia participated in the study. More than two-thirds of 203 (67.7%) of the participants were males, and 116 (38.7%) participants were between the ages of 28 and 37 years. We found that the prevalence of suicide behavior among PWS was 30.3%. Being unemployed ( AOR = 3.65 , CI = 1.32 , 10.05), family history of suicide ( AOR = 3.16 , CI = 1.38 , 7.23), substance use ( AOR = 2.51 , CI = 1.13 , 5.59), current positive psychotic symptoms (hallucination ( AOR = 6.39 , CI = 2.86 , 14.29), and delusion ( AOR = 4.15 , CI = 1.95 , 14.29) and presence of comorbid depression ( AOR = 4.81 , CI = 1.98 , 11.68) were independent significant predictors with suicidal behavior in PWS. Conclusion. The prevalence of suicidal behavior among PWS was found to be high. Hence, designing strategies for early screening and intervention is the most critical prevention strategy of suicide in PWS.

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