Bipolar Affective Disorder in Intellectual Disability

2020 ◽  
pp. 117-128 ◽  
Author(s):  
Samuel Tromans ◽  
Ian Jones ◽  
Ignatius Gunaratna ◽  
Natalie Orr ◽  
Sabyasachi Bhaumik
Keyword(s):  
Intellectual Disability ◽  
General Population ◽  
Affective Disorder ◽  
Adult Population ◽  
Bipolar Affective Disorder ◽  
Classification Systems ◽  
Recommended Treatment ◽  
General Adult Population ◽  
Genetic And Environmental Factors ◽  
The Individual

People with Intellectual Disability (ID) experience Bipolar Affective Disorder (BPAD) at a rate probably similar to that of the general population, though diagnosis may be delayed or missed owing to numerous factors, including communication deficits and atypical clinical presentations, especially in those with more severe ID. BPAD is caused by an interaction of genetic and environmental factors, and associated with numerous other forms of psychiatric and physical illness. Diagnostic criteria used for the general population may have clinical utility for those with milder ID, though ID-specific classification systems may be more useful in those with moderate-severe ID. There has been limited research regarding treatment of BPAD in individuals with ID. However, NICE guidelines have recommended treatment in line with that of the general adult population. Treatment decisions should be a collaborative process wherever possible, involving the patient, carer, clinician, and other health professionals. Factors specific to the individual patient should be taken into account in any subsequent therapeutic approach, including the acceptability of blood test monitoring and comorbid illness, among other factors.

Types of Mental Disorders in People with Intellectual Disability

2020 ◽  
pp. 55-60
Author(s):  
Sally-Ann Cooper
Keyword(s):  
Intellectual Disability ◽  
General Population ◽  
Mental Disorders ◽  
Mental Disorder ◽  
Bipolar Affective Disorder ◽  
Hyperactivity Disorder ◽  
Dsm 5 ◽  
Icd 10 ◽  
Physical Disorders ◽  
Challenging Behaviours

Mental disorders are common in people with intellectual disability, with a reported point prevalence of 36% in children and young people (including challenging behaviours), and 40.9% in adults (or 28.3% excluding challenging behaviours). People with intellectual disability experience all types of mental disorders, some more commonly than the general population, e.g. autism, attention-deficit hyperactivity disorder, schizophrenia, bipolar affective disorder, and dementia. Challenging behaviours are also common, and have no clear general population equivalent. Multi-morbidity of mental and physical disorders is typical. Mental disorder assessments are complex due to multi-morbidity and polypharmacy, in addition to impairments in communication, understanding, vision, and hearing, and the need to work with family and paid carers as well as the person with intellectual disability. Mental disorder classificatory systems have been developed for people with intellectual disability, in view of under-reporting when using general population manuals: DC-LD was designed to complement ICD-10, and DM-ID 2 to interpret DSM-5.

scholarly journals Prevalence and clinical associations of wheezes and crackles in the general population: the Tromsø study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
J. C. Aviles-Solis ◽  
C. Jácome ◽  
A. Davidsen ◽  
R. Einarsen ◽  
S. Vanbelle ◽  
...  
Keyword(s):  
Lung Function ◽  
General Population ◽  
Smoking Status ◽  
Adult Population ◽  
Female Gender ◽  
Lung Sounds ◽  
Current Smoking ◽  
General Adult Population ◽  
Multivariable Analyses ◽  
Logistic Regressions

Abstract Background Wheezes and crackles are well-known signs of lung diseases, but can also be heard in apparently healthy adults. However, their prevalence in a general population has been sparsely described. The objective of this study was to determine the prevalence of wheezes and crackles in a large general adult population and explore associations with self-reported disease, smoking status and lung function. Methods We recorded lung sounds in 4033 individuals 40 years or older and collected information on self-reported disease. Pulse oximetry and spirometry were carried out. We estimated age-standardized prevalence of wheezes and crackles and associations between wheezes and crackles and variables of interest were analyzed with univariable and multivariable logistic regressions. Results Twenty-eight percent of individuals had wheezes or crackles. The age-standardized prevalence of wheezes was 18.6% in women and 15.3% in men, and of crackles, 10.8 and 9.4%, respectively. Wheezes were mostly found during expiration and crackles during inspiration. Significant predictors of expiratory wheezes in multivariable analyses were age (10 years increase - OR 1.18, 95%CI 1.09–1.30), female gender (1.45, 1.2–1.8), self-reported asthma (1.36, 1.00–1.83), and current smoking (1.70, 1.28–2.23). The most important predictors of inspiratory crackles were age (1.76, 1.57–1.99), current smoking, (1.94, 1.40–2.69), mMRC ≥2 (1.79, 1.18–2.65), SpO2 (0.88, 0.81–0.96), and FEV1 Z-score (0.86, 0.77–0.95). Conclusions Nearly over a quarter of adults present adventitious lung sounds on auscultation. Age was the most important predictor of adventitious sounds, particularly crackles. The adventitious sounds were also associated with self-reported disease, current smoking and measures of lung function. The presence of findings in two or more auscultation sites was associated with a higher risk of decreased lung function than solitary findings.

Mind the Gap

2016 ◽  
pp. 11-32 ◽  
Author(s):  
Valsamma Eapen ◽  
Amelia Walter
Keyword(s):  
Mental Health ◽  
Intellectual Disability ◽  
General Population ◽  
Mental Health Problems ◽  
Accurate Diagnosis ◽  
Classification Systems ◽  
Psychiatric Classification ◽  
Service Delivery Models ◽  
Multiple Challenges ◽  
Delivery Models

Individuals with Intellectual Disability (ID) experience higher rates of psychiatric disorders than the general population, although findings are mixed with regard to the determinants of this increased prevalence. Despite growing recognition of the prevalence of mental health problems among individuals with ID, and the consequences this comorbidity carries for individuals, families and the wider community, there are multiple challenges in identifying and managing these concerns. Accurate diagnosis and effective intervention is currently hindered by factors including the applicability of standardised psychiatric classification systems, gaps in service delivery models and access to such services, as well as unmet training needs.

A Comparative Study of Perceived Stress and Anxiety, among Patients with Bipolar Affective Disorder, and the General Population, during COVID-19 Pandemic, Conducted in Government Hospital for Mental Care, Visakhapatnam

2021 ◽  
Vol 8 (17) ◽  
pp. 1169-1173
Author(s):  
Evani Ramachandra Rao ◽  
Seelam Satish
Keyword(s):  
Mental Health ◽  
General Population ◽  
Affective Disorder ◽  
Perceived Stress ◽  
Health Professionals ◽  
Psychiatric Illness ◽  
Bipolar Affective Disorder ◽  
Government Hospital ◽  
Mental Care ◽  
Exacerbation Of Symptoms

BACKGROUND Generally during pandemic, mental health needs are largely neglected and patients with psychiatric illness are given less medical care as majority of the health professionals are involved in acute management of the pandemic. In this study we wanted to determine the difference between stress and anxiety in patients with bipolar affective disorder (BPAD) and the general population. METHODS It was a cross sectional study and convenient sampling was used. The study was conducted in Government Hospital for Mental Care, Visakhapatnam. The study included 60 participants of whom 30 participants are patients with bipolar affective disorder who were currently in remission and 30 participants were from general population and were evaluated using semi structured proforma for sociodemographic data and perceived stress scale to assess perceived stress, Hamilton anxiety rating scale to assess anxiety. Results were analyzed statistically. RESULTS The results showed statistically significant difference in severity of perceived stress and anxiety among patients with bipolar affective disorder and the general population. CONCLUSIONS Our study results re-emphasize the fact that there should be an increased awareness about patients with psychiatric illness like bipolar affective disorder as targets for care with regular psychiatric intervention during Covid-19 pandemic. With our study, we want to re-iterate the fact that patients with psychiatric illness experience exacerbation of symptoms during infectious disease epidemic. Patients diagnosed with bipolar affective disorder can also have comorbid anxiety disorder, even after treating the mood disorder episode. Residual anxiety may persist and in times of infectious diseases epidemic, these anxiety symptoms will exacerbate leading to poor quality of life and non-compliance to medication. With our study we want to recommend that proper care and regular follow-up schedules have to be formulated by mental health professionals and mental health institutions to reduce and prevent exacerbation of symptoms and improve treatment compliance which in turn helps in preventing relapse of bipolar affective disorder. KEYWORDS Bipolar Affective Disorder, Perceived Stress, Anxiety, Covid-19

scholarly journals Use of ECT in patients with an intellectual disability: review

2012 ◽  
Vol 36 (2) ◽  
pp. 55-60 ◽  
Author(s):  
Jessica Collins ◽  
Neel Halder ◽  
Nasim Chaudhry
Keyword(s):  
Intellectual Disability ◽  
Electroconvulsive Therapy ◽  
Case Reports ◽  
Adult Population ◽  
Retrospective Chart Review ◽  
Positive Outcome ◽  
Severity Of Disability ◽  
General Adult Population ◽  
Valuable Treatment ◽  
Diagnostic Difficulties

Aims and methodThe literature on the use of electroconvulsive therapy (ECT) in patients with an intellectual disability is scarce, despite a higher prevalence of psychiatric disorders than in the general adult population. We carried out a review of articles published before March 2010. All age ranges, severity of disability and diagnoses were included.ResultsWe found 72 case reports, a retrospective chart review study and other reviews, but no controlled studies. Most patients (79%) showed a positive outcome following ECT. Complications were seen only in 13% and there were no reports of cognitive decline. Many patients relapsed following ECT (32%) and the majority were maintained with medication at follow-up (71%).Clinical implicationsElectroconvulsive therapy is a valuable treatment for this patient group and should be considered earlier as opposed to as a last resort. Obstacles to its use include diagnostic difficulties, ethical and legal issues, a lack of objective measurements and uncertainty about its safety in this population.

Psychological Needs of Professional Police Personnel

1973 ◽  
Vol 33 (1) ◽  
pp. 313-314 ◽  
Author(s):  
William E. Simon ◽  
Veronica Wilde ◽  
Robert M. Cristal
Keyword(s):  
General Population ◽  
Adult Population ◽  
Psychological Needs ◽  
Police Work ◽  
College Males ◽  
Personal Preference ◽  
Police Personnel ◽  
Edwards Personal Preference Schedule ◽  
General Adult Population

The psychological needs, as measured by the Edwards Personal Preference Schedule, of a sample of 29 male county police personnel were compared to the EPPS needs of normative samples of males selected from the general population and college males. The police personnel differed significantly from general adult population males on 9 of the 15 EPPS needs and from college males on 7. The EPPS needs of Ss who had been involved in police work for more than 6 yr. were not different from those of Ss who had been involved in police work for less than 6 yr.

A PubMed Citations Search Study on the Prevalence of Epiphora in the General Adult Population

2020 ◽  
Vol 237 (04) ◽  
pp. 527-530
Author(s):  
Ivan O. Haefliger ◽  
Yasmina D. Haefliger ◽  
Ana Rosa Pimentel de Figueiredo
Keyword(s):  
General Population ◽  
Dry Eye ◽  
Adult Population ◽  
Large Population ◽  
Population Based ◽  
Database Search ◽  
Medical Subject Headings ◽  
General Adult Population ◽  
Pubmed Search ◽  
Number Of Citations

Abstract Purpose To assess the prevalence of epiphora in the general adult population based on PubMed search citations. Methods 1) Electronic PubMed MEDLINE database search (September 13, 2019) with the terms (Medical Subject Headings or MeSH) “prevalence” and “epiphora”, 2) “epiphora” and “dry eye”, and 3) “prevalence”, “epiphora”, and “dry eye”. Review of all citations from these searches containing the term “epiphora” either in their abstract or title. Results 1) PubMed search retrieved 2 617 137 citations for “prevalence”, 26 135 for “epiphora”, and 2554 for “prevalence” AND “epiphora”. Within the latter 2554 citations, the word “epiphora” appeared in the abstract or title of only 109 citations (< 5%). None of these 109 citations assessed the prevalence of epiphora in the adult general population as the primary end point. Only one abstract mentioned that out of 125 patients, 7.2% indicated, retrospectively, that they had already had epiphora before cataract surgery. Two large population-based studies addressed the incidence of epiphora, not in adults, but in infants (20%) and children (7.7%). 2) The PubMed search showed 22 487 citations for “dry eye”, 30 211 for “epiphora” OR “dry eye”, and up to 18 414 joint citations for the terms “epiphora” AND “dry eye”. These 18 414 citations were 70 and 82% of the number of MeSH citations for “epiphora” and “dry eye” alone, respectively. Of these 18 414 citations, the word “epiphora” only appeared in 131 citations (< 1%), one of them being an extra report mentioning a 32% incidence of epiphora among postmenopausal women. 3) The search found 2206 citations for “prevalence” AND “epiphora” AND “dry eye”, with only 10 of them (< 1%) containing the word “epiphora”. Conclusions Despite a large number of citations retrieved by PubMed searches, there seems to be a lack of studies on the prevalence of epiphora in the adult general population. There is apparently also a large number of overlapping PubMed citations retrieved for searches with the terms “epiphora” AND “dry eye”, although more than 99% of them did not even display the word “epiphora”. Although epiphora is considered a common complain, its prevalence in the adult general population deserves to be further assessed.

scholarly journals Use of Dermatoglyphic Parameters as Possible Markers in Bipolar Affective Disorder

2021 ◽  
Vol 11 (7) ◽  
pp. 385-393
Author(s):  
Amit Kumar Pal ◽  
Sagarika Ray ◽  
Jishnu Bhattacharya
Keyword(s):  
Bipolar Disorder ◽  
Affective Disorder ◽  
Bipolar Affective Disorder ◽  
Control Group ◽  
Healthy Controls ◽  
Ridge Count ◽  
Primordial Prevention ◽  
And Gender ◽  
The Individual ◽  
Bipolar Patients

Background: Bipolar affective disorder is an episodic illness characterized by fluctuating mood states. Association of dermatoglyphic traits with bipolar affective disorder has been observed in various studies. This study was undertaken to evaluate epidermal ridge patterns in bipolar patients as compared to healthy controls attending a super speciality district hospital in West Bengal. Context and purpose of study: Establishing dermatoglyphic parameters as biomarkers for early diagnosis and consequently, prompt intervention in bipolar affective disorder will ensure a greater scope of recovery, and thus promote a better quality of life for the individual as well as lower the burden of disease for the society. Methods: Quantitative dermatoglyphic parameters namely, Total Finger Ridge Count (TFRC), Total A-B Ridge Count (TABRC), and ATD Angle of 100 bipolar patients were compared to 100 age and gender matched healthy controls. Results: Statistically significant differences were found on comparing the dermatoglyphic parameters between cases and controls. TFRC was found to be decreased while ATD angle was increased in bipolar cases, as compared to the control group. However, no significant change was observed in TABRC between the two groups. Conclusions: This study found a significant association between dermatoglyphic pattern anomalies and the development of bipolarity. This may offer a scope of primordial prevention of bipolar disorder in future. Key words: Dermatoglyphics, ridge pattern, bipolar disorder, Total Finger Ridge Count (TFRC), Total A-B Ridge Count (TABRC), ATD angle.

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