Age-at-First-Registration and Heterogeneity in Affective Psychoses

2003 ◽  
Vol 37 (1) ◽  
pp. 66-69 ◽  
Author(s):  
Joy L. Welham ◽  
Richard Thomis ◽  
John J. Mcgrath

Background: Previous research into age of onset in affective disorders has produced conflicting results. This paper examines the influence of heterogeneity on the age-at-firstregistration distribution for the ICD-9 diagnostic group ‘affective psychosis’. Method: For 1979–1991, data for age-at-first-registration for 4985 individuals diagnosed with affective psychosis (ICD-9 296.x) were extracted from a name-linked mental health register. These data were divided into (i) ‘296.1 only’, a category used to code unipolar depression (males = 700; females = 1321); and (ii) ‘296 other’, all 296 cases other than 296.1 (males = 1280; females = 1684). Inception rates for each 5-year age division were adjusted for the background population age-structure as a rate per 100 000 population. Results: The age-at-first-registration distribution for affective psychosis has a wide age range, with women outnumbering men. There is a near-linear increase in inception rates for both men and women with 296.1 only, while the bulk of those with affective psychoses (296 other) have an inverted U-shaped age distribution. Males have an earlier modal age-atfirst-registration for 296 other compared to females. Conclusion: The heterogeneity in terms of subtypes and sex in affective psychosis clouds the interpretation of age-at-first-registration. Separating those with unipolar psychotic depression from other subclassifications and differentiating by sex may provide clues to factors that precipitate the onset of affective psychosis.

1995 ◽  
Vol 166 (5) ◽  
pp. 601-606 ◽  
Author(s):  
Alan S. Brown ◽  
Ezra S. Susser ◽  
Shang P. Lin ◽  
Richard Neugebauer ◽  
Jack M. Gorman

BackgroundPrenatal and perinatal factors have been linked to affective disorders. We therefore undertook an exploratory study to determine whether prenatal exposure to severe famine was associated with an increased risk of affective disorders.MethodMonthly birth cohorts that were exposed and unexposed to the Dutch Hunger Winter of 1944–45 were identified. The cumulative incidences of affective psychoses and neurotic depression (ICD–9 criteria) were compared between exposed and unexposed cohorts during each trimester of gestation.ResultsThe relative risk (RR) of affective psychosis (broad and restricted definitions) among persons exposed to famine during the second trimester was significantly increased (broad: RR (95% confidence interval) = 1.62 (1.19, 2.20); restricted: 1.59 (1.14, 2.21)). Separate analysis by gender showed a significant association among males (broad: 2.26 (1.43, 3.57); restricted: 2.40 (1.49, 3.89)), but not females (broad: 1.28 (0.84, 1.94); restricted: 1.17 (0.73, 1.86)). The risk of neurotic depression was not increased after prenatal famine exposure.ConclusionsThese results suggest a possible relationship between prenatal famine during the second trimester and affective psychosis, lending plausibility to reports that have associated affective psychoses with prenatal exposures. Further studies of this relationship are warranted.


1977 ◽  
Vol 131 (5) ◽  
pp. 478-485 ◽  
Author(s):  
Olga Trzebiatowska-Trzeciak

The mode of inheritance of affective psychoses was studied in 800 first degree and 582 second degree relatives of 122 probands. Morbidity risk for unipolar depression was 12·0±3·2 and 11·4±2·7 per cent respectively for parents and siblings of probands suffering from unipolar depression. Morbidity risk for manic-depressive psychosis for the respective groups of first degree relatives of manic-depressive probands was 15·1±3·2 and 16·9±3·2 per cent. In second degree relatives the morbidity risk was 3·4±1·0 and 5·3±1·4 per cent for unipolar depression and manic-depressive psychosis respectively.The results indicate the role of genetical factors in the etiology of both types of affective disorder and show that unipolar depression and manic-depressive psychosis are distinct entities. The hypothesis of X-linked dominant transmission was not confirmed in either of these affective disorders. By means of the computational model of Slater, no results compatible with a polygenic inheritance of unipolar depression or manic-depressive psychosis were found.


1985 ◽  
Vol 147 (2) ◽  
pp. 180-187 ◽  
Author(s):  
John M. Eagles ◽  
Lawrence J. Whalley

SummaryFirst admission rates from 1969–78 for Scottish psychiatric units were calculated for discharge diagnoses of affective psychosis for each five-year age-group from 15 years to over 74 years. There were clear-cut linear increases in rates of depressive psychoses, mania, and all affective psychoses, consistent with a relatively steady increase in the rate of first-onset affective psychoses with increasing age. These findings are discussed in terms of social, psychological, and biological hypotheses of the causes of affective disorder. It is argued that no single factor could produce the observed linear increases with age and that the data appear more consistent with an integrative aetiological model of affective disorder.


2020 ◽  
Vol 63 (6) ◽  
pp. 40-50
Author(s):  
Hugo Enrique Hernández-Martínez ◽  
Marta Georgina Ochoa-Madrigal

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.


2021 ◽  
Vol 10 (7) ◽  
pp. 1381
Author(s):  
Hun-Ju Yu ◽  
Meng-Ni Chuang ◽  
Chiao-Lun Chu ◽  
Pei-Lin Wu ◽  
Shu-Chen Ho ◽  
...  

Kawasaki disease (KD) is a systemic vasculitis that primarily affects children under the age of 5 years old. The most significant complication is coronary artery lesions, but several ocular manifestations have also been reported. Recently, one study revealed an increasing incidence of myopia among KD patients. Therefore, the aim of this study was to assess the difference in myopic incidence between Kawasaki disease (KD) patients treated with aspirin and intravenous immunoglobulin (IVIG). Materials and methods: We carried out a nationwide retrospective cohort study by analyzing the data of KD patients (ICD-9-CM code 4461) from Taiwan’s National Health Insurance Research Database (NHIRD) during the period of 1996–2013. Results: A total of 14,102 diagnosed KD were found in Taiwan during the study period. After excluded missing data, treatment strategy and age distribution, a total of 1446 KD patients were enrolled for analysis including 53 of which received aspirin (without IVIG) and 1393 of which were treated with IVIG. Patients who had myopia, astigmatism, glaucoma, cataract, etc. prior to their KD diagnosis were excluded. The age range was 0 to 6 years old. According to the cumulative curves, our results demonstrated that the myopic incidence in the IVIG group was significantly lower than the aspirin group (hazard ratio: 0.59, 95% confidence intervals: 0.36~0.96, p = 0.02). Treatment with IVIG for KD patients may have benefit for myopia control. Conclusion: Compared to aspirin, IVIG may decrease the myopic risk in KD patients. However, it needs further investigation including clinical vision survey of myopia due to the limitations of this population-based study.


2000 ◽  
Vol 176 (6) ◽  
pp. 523-526 ◽  
Author(s):  
M. Bain ◽  
E. Juszczak ◽  
K. McInneny ◽  
R. E. Kendell

BackgroundUnlike schizophrenia, little interest has been taken in the incidence of obstetric complications in affective psychoses.AimsTo find out whether obstetric complications are more common in affective psychoses than matched controls.MethodTwo hundred and seventeen probands with an in-patient diagnosis of affective psychosis who had been born in Scotland in 1971–74, and a further 84 born in 1975–78, were closely matched with controls and the incidence of obstetric complications in the two compared using obstetric data recorded in a set format shortly after birth.ResultsAbnormal presentation of the foetus was the only complication significantly more common in the affective probands in the 1971–74 birth cohort and artificial rupture of the membranes was the only event more common in the probands in the 1975–78 cohort. Both are probably chance findings.ConclusionIt is unlikely that the incidence of obstetric complications is raised in people with affective psychoses of early onset.


PEDIATRICS ◽  
1978 ◽  
Vol 62 (6) ◽  
pp. 1021-1025
Author(s):  
Gerald R. Greene

A 4-month-old female infant with meningitis caused by Haeinophilus influenzae type f had a hospital course complicated by sterile subclural effusions and persistent neurologic normalities. One year later she was normal in all respects. The infant's mother had serum bactericidal antibodies to H. influenzae type b but not to type f. During recovery the patient had no bactericidal antibodies to type b, and the type f organism could not be maintained in her serum. Review of the literature identified 40 cases of meningitis reported as caused by H. influenzae other than type b. An evaluation of the ten cases described as due to encapsulated strains (a, e, and f) shows that the age distribution and clinical features are similar to those of meningitis caused by type b. Only five cases of meningitis caused by unencapsulated H. influenzae have been described. Four of the patients were older than the usual age range for type b meningitis and two had prior head trauma. A large clinical trial in Finland with a two-year observation period has denionstrated no untoward increase in non-b H. influenzae meningitis in recipients of a type b vaccine. Serious infections caused by other H. influenzae types will continue to occur sporadically and may increase in frequency when an effective vaccine against type b is widely used in infants.


2004 ◽  
Vol 28 (12) ◽  
pp. 438-440 ◽  
Author(s):  
Eromona Whiskey ◽  
David Taylor

Aims and MethodTo review the evidence for this use of pramipexole in the treatment of unipolar and bipolar depression, a literature search on Embase and Medline was conducted in December 2003. The search was updated in July 2004. The reference sections of retrieved papers were searched for further relevant references.ResultsThere are limited data on the clinical use of pramipexole in affective disorders. Only two double-blind trials in bipolar depression and one in unipolar depression were retrieved. Most information is in the form of case reports and open studies. No dose-response relationships have been established and a wide range of doses has been employed in the reports.Clinical ImplicationsIn view of the fact that the evidence for the use of pramipexole is still limited at the time of writing, its routine clinical use cannot be recommended. The data appear promising, but further research is required to determine its role in affective disorders.


2017 ◽  
Author(s):  
Hasan A Baloch ◽  
Jair C. Soares

Affective disorders are among the most common disorders in psychiatry. They are generally classified according to the persistence and extent of symptoms and by the polarity of these symptoms. The two poles of the affective spectrum are mania and depression. Bipolar disorder is characterized by the presence of the mania or hypomania and often depression. Unipolar depression is defined by depression in the absence of a lifetime history of mania or hypomania. These differences are not merely categorical but have important implications for the prognosis and treatment of these conditions. Bipolar disorder, for example, is better treated using mood-stabilizing medication, whereas unipolar depression responds optimally to antidepressant medications. In addition, prognostically, unipolar depression may sometimes be limited to one episode in a lifetime, whereas bipolar disorder is typically a lifelong condition. The course of both conditions, however, is often chronic, and frequently patients can present with unipolar depression only to later develop manic symptoms. A thorough understanding of both conditions is therefore required to treat patients presenting with affective symptomatology. This chapter discusses the epidemiology, etiology and genetics, pathogenesis, diagnosis, and treatment of unipolar depression and bipolar disorder. Figures illustrate gray matter differences with lithium use and the bipolar spectrum. Tables list the pharmacokinetics of commonly used antidepressants and medications commonly used in the treatment of bipolar disorder. This review contains 2 figures, 2 tables, and 136 references.


1993 ◽  
Vol 34 (3) ◽  
pp. 187-191 ◽  
Author(s):  
Richard C. Evenson ◽  
Scott T. Meier ◽  
Brian J. Hagan

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