Mood disorders

2015 ◽  
Author(s):  
Jayesh Kamath ◽  
Ajay Shah
Keyword(s):  
Mood Disorders ◽  
Best Practice ◽  
Depressive Disorders ◽  
Suicide Attempts ◽  
Medication Management ◽  
Strong Association ◽  
Bipolar Disorders ◽  
Correctional Setting ◽  
Increased Risk ◽  
Correctional Settings

Depression and Bipolar Disorder comprise a substantial percentage of all psychiatric care in the community. This is also the case in correctional settings. Diagnosis and treatment may vary in multiple ways, given the context and characteristics of jails and prisons. Reassessment of symptomatology at every visit, especially in the first few months of incarceration, enhances accurate diagnosis. The clinical presentation of many individuals at the time of incarceration is frequently confounded by substance withdrawal, adjustment issues, and other comorbidities. The clinical picture frequently evolves and allows improved accuracy over weeks to months. Decades of research conducted in the community and correctional settings have shown a close but controversial relationship between mood disorders, aggression, and criminality. This may be reflected in a substantially increased risk of multiple incarcerations as with the observation that inmates with bipolar disorders are 3.3 times more likely to have had four or more previous incarcerations compared with inmates who had no major psychiatric disorders. In terms of management risks, studies conducted with both genders in the correctional setting have shown a strong association between depression and near-lethal suicide attempts. Data reflect the importance of both psychotherapy and targeted, thoughtful medication management in the effective treatment of mood disorders. This chapter discusses the data and those characteristics, as well as core management, best-practice, and evidence based therapeutic approaches to the treatment of major depressive disorders and bipolar disorders in jails and prisons.

Suicide risk management

2017 ◽  
Author(s):  
Kerry C. Hughes ◽  
Jeffrey L. Metzner
Keyword(s):  
Risk Reduction ◽  
Suicide Risk ◽  
Best Practice ◽  
Suicide Attempts ◽  
Active Management ◽  
Root Cause ◽  
Increased Risk ◽  
Correctional Settings ◽  
Continued Learning ◽  
Staff Intervention

There are many risks associated with incarceration, and a substantial one is suicide. Virtually every completed suicide generates litigation. Prevalence, demographics, trends, screening and assessment of suicide risk, and recognition of the key factors associated with increased risk and managing that risk safely and appropriately in jails is presented. The factors relating to increasing suicide risk in prisons are often quite distinct from other correctional settings. Issues such as restrictive housing, facility transfers, loss of community social supports, and chronic management all play potential roles. Proactive recognition of such concerns and active management is critical to effective risk reduction. This chapter discusses such factors in the context of changing prison dynamics and trends. Following completed suicides, a formal protocol is often followed to assist staff in understanding the events that led to the suicide and specifically intervening to address staff feelings that follow such a trauma. Such a process assists quality improvement initiatives, whether in the form of a root cause analysis or other format. Best practice approaches to post-mortem review and staff intervention/ support have been developed and are in use in many facilities. Working to eliminate or reduce the frequency of suicide attempts absolutely requires a staff culture committed to continued learning and improving of both knowledge and skills. This chapter presents a review of the current standards of suicide risk reduction training.

Suicide risk management

2015 ◽  
Author(s):  
Kerry C. Hughes ◽  
Jeffrey L. Metzner
Keyword(s):  
Risk Reduction ◽  
Suicide Risk ◽  
Best Practice ◽  
Suicide Attempts ◽  
Active Management ◽  
Root Cause ◽  
Increased Risk ◽  
Correctional Settings ◽  
Continued Learning ◽  
Staff Intervention

There are many risks associated with incarceration, and a substantial one is suicide. Virtually every completed suicide generates litigation. Prevalence, demographics, trends, screening and assessment of suicide risk, and recognition of the key factors associated with increased risk and managing that risk safely and appropriately in jails is presented. The factors relating to increasing suicide risk in prisons are often quite distinct from other correctional settings. Issues such as restrictive housing, facility transfers, loss of community social supports, and chronic management all play potential roles. Proactive recognition of such concerns and active management is critical to effective risk reduction. This chapter discusses such factors in the context of changing prison dynamics and trends. Following completed suicides, a formal protocol is often followed to assist staff in understanding the events that led to the suicide and specifically intervening to address staff feelings that follow such a trauma. Such a process assists quality improvement initiatives, whether in the form of a root cause analysis or other format. Best practice approaches to post-mortem review and staff intervention/ support have been developed and are in use in many facilities. Working to eliminate or reduce the frequency of suicide attempts absolutely requires a staff culture committed to continued learning and improving of both knowledge and skills. This chapter presents a review of the current standards of suicide risk reduction training.

scholarly journals Astroglial Connexin43 as a Potential Target for a Mood Stabiliser

2020 ◽  
Vol 22 (1) ◽  
pp. 339
Author(s):  
Motohiro Okada ◽  
Tomoka Oka ◽  
Misaki Nakamoto ◽  
Kouji Fukuyama ◽  
Takashi Shiroyama
Keyword(s):  
Gap Junction ◽  
Mood Disorders ◽  
Depressive Disorders ◽  
Bipolar Disorders ◽  
Depressive Mood ◽  
The Other ◽  
Health Concern ◽  
Monoamine Transporter ◽  
Other Hand ◽  
Novel Strategy

Mood disorders remain a major public health concern worldwide. Monoaminergic hypotheses of pathophysiology of bipolar and major depressive disorders have led to the development of monoamine transporter-inhibiting antidepressants for the treatment of major depression and have contributed to the expanded indications of atypical antipsychotics for the treatment of bipolar disorders. In spite of psychopharmacological progress, current pharmacotherapy according to the monoaminergic hypothesis alone is insufficient to improve or prevent mood disorders. Recent approval of esketamine for treatment of treatment-resistant depression has attracted attention in psychopharmacology as a glutamatergic hypothesis of the pathophysiology of mood disorders. On the other hand, in the last decade, accumulated findings regarding the pathomechanisms of mood disorders emphasised that functional abnormalities of tripartite synaptic transmission play important roles in the pathophysiology of mood disorders. At first glance, the enhancement of astroglial connexin seems to contribute to antidepressant and mood-stabilising effects, but in reality, antidepressive and mood-stabilising actions are mediated by more complicated interactions associated with the astroglial gap junction and hemichannel. Indeed, several depressive mood-inducing stress stimulations suppress connexin43 expression and astroglial gap junction function, but enhance astroglial hemichannel activity. On the other hand, monoamine transporter-inhibiting antidepressants suppress astroglial hemichannel activity and enhance astroglial gap junction function, whereas several non-antidepressant mood stabilisers activate astroglial hemichannel activity. Based on preclinical findings, in this review, we summarise the effects of antidepressants, mood-stabilising antipsychotics, and anticonvulsants on astroglial connexin, and then, to establish a novel strategy for treatment of mood disorders, we reveal the current progress in psychopharmacology, changing the question from “what has been revealed?” to “what should be clarified?”.

Epidemiology of mood disorders

2012 ◽  
pp. 645-650
Author(s):  
Peter R. Joyce
Keyword(s):  
Major Depression ◽  
Mood Disorders ◽  
Disease Burden ◽  
Depressive Disorders ◽  
Bipolar Disorders ◽  
Developed Countries ◽  
Disability Adjusted Life ◽  
Life Years ◽  
The World ◽  
Unipolar Major Depression

The Global Burden of Disease, which is a comprehensive assessment of mortality and disability from diseases and injuries in 1990 and projected to 2020, highlights the importance of mood disorders for the world. Using the measure of disability-adjusted life years, it was determined that unipolar major depression was the fourth leading cause of disease burden in the world. It was also projected that, in the year 2020, unipolar major depression would be the second leading cause of disease burden in the world. Disabilityadjusted life years is based on both mortality and disability. If one looks at disability alone, then unipolar major depression was the leading cause of disability in the world in 1990, and bipolar disorder was the sixth leading cause. Across the world, 10.7 per cent of disability can be attributed to unipolar major depression and, in developed countries, unipolar major depression contributes to nearly 20 per cent of disease burden in women aged from 15 to 44 years. This chapter addresses bipolar disorders and depressive disorders, covering diagnostic issues, prevalence, comorbidity, use of health services, and risk factors for both types of disorder.

scholarly journals Association of Insomnia, Depressive Disorders, and Mood Disorders as Risk Factors With Breast Cancer: A Nationwide Population-Based Cohort Study of 232,108 Women in Taiwan

2021 ◽  
Vol 11 ◽  
Author(s):  
Hui-Pu Liu ◽  
James Cheng-Chung Wei ◽  
Hei-Tung Yip ◽  
Ming-Hsin Yeh
Keyword(s):  
Breast Cancer ◽  
Cohort Study ◽  
Incidence Rate ◽  
Mood Disorders ◽  
Depressive Disorders ◽  
Population Based ◽  
General View ◽  
Research Database ◽  
Sleep Medication ◽  
Increased Risk

BackgroundInsomnia, depressive disorders, and to a more general view, mood disorders are raising people’s concerns and causing disability of life. Herein, we try to seek the association of such illnesses with subsequent breast cancer.MethodsThis population-based, retrospective cohort study used data from the Taiwan National Health Insurance Research Database. This study included 232,108 women diagnosed with insomnia, depressive disorders, and mood disorders from January 1, 2000 to December 31, 2013. Physician diagnosed insomnia, depressive disorders, or mood disorders using outpatient and inpatient records before diagnosis of breast cancer. Cox proportional hazards regression analysis is adjusted for women with insomnia, depressive disorders, mood disorders, and other factors like insured amount, urbanization, and comorbidities such as having subsequent breast cancer.ResultsSleep medication was associated with a significantly increased incidence rate of breast cancer (aHR = 1.23 (95% CI = 1.13, 1.35), p < 0.001). Insomnia was associated with significant increased hazard of breast cancer (aHR = 1.16 (95% CI = 1.07, 1.27), p < 0.001). Annual insured amount >20,000 (TWD), high urbanization area, and hyperlipidemia were associated with increased hazard of breast cancer (aHR = 1.13 (95% CI = 1.01, 1.27), p = 0.04; aHR = 1.41 (95% CI = 1.17, 1.71), p < 0.001; aHR = 1.14 995% CI = 1.02, 1.29), p = 0.02, respectively). There was a positive correlation between depressive disorders and increased incidence rate of breast cancer but not statistically significant (aHR = 1.11 (95% CI = 0.99, 1.25), p = 0.08). Mood disorders were not associated with increased hazard (aHR = 1.11 (95% CI = 0.91, 1.34), p = 0.31).ConclusionIn this study, women with insomnia had increased risk of breast cancer, particularly those in high urbanization or with high insured amounts. Sleep medication (benzodiazepine (BZD) or non-BZD) and hyperlipidemia were independently associated with a higher hazard ratio of breast cancer. Insomnia along with sleep medication did not yield more hazards than each alone. Mood disorders appeared to be not associated with subsequent breast cancer. However, depressive disorders, the subgroups of mood disorders, could possibly increase the incidence rate of breast cancer though not statistically significant.

Overview of mood disorders: diagnosis, classification, and management

1994 ◽  
Vol 40 (2) ◽  
pp. 273-278 ◽  
Author(s):  
J Fawcett
Keyword(s):  
Side Effects ◽  
Clinical Research ◽  
Mood Disorders ◽  
Treatment Efficacy ◽  
Depressive Disorders ◽  
Medication Management ◽  
Clinical Depression ◽  
Treatment Responses ◽  
Diagnosis Classification ◽  
Physical Morbidity

Abstract This discussion of the diagnosis, classification, and epidemiology of clinical depression includes details of the associated physical morbidity, mortality, and impairment. Treatment approaches to depressive disorders are categorized with an emphasis on medication management, including improved treatment efficacy and progress with respect to side effects and toxicity. Although considerable advances have been made, with 18 antidepressant compounds being available and the impending release of two new antidepressant compounds in 1994, no one agent has demonstrated greater efficacy than another. Currently available studies suggest that only 21-42% of patients entered into treatment reach full recovery, while 20% of patients do not respond to available treatment but remain chronically depressed. Thus, the development of more efficacious agents that will produce complete remissions in patients who now achieve only partial treatment responses is a major challenge for biochemical, pharmacological, and clinical research of the treatment of mood disorders.

Increased risk of hospital admission for mood disorders following admission for epilepsy

Neurology ◽  
2018 ◽  
Vol 91 (9) ◽  
pp. e800-e810 ◽  
Author(s):  
Anna M. Kim ◽  
Kyle C. Rossi ◽  
Nathalie Jetté ◽  
Ji Yeoun Yoo ◽  
Kenneth Hung ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Hospital Admission ◽  
Mood Disorders ◽  
Cox Regression ◽  
Bipolar Disorders ◽  
Medical Group ◽  
Index Hospitalization ◽  
Increased Risk ◽  
Stroke Group ◽  
Nationally Representative

ObjectiveTo determine if epilepsy admissions, compared to admissions for other medical causes, are associated with a higher readmission risk for mood disorders.MethodsThe Nationwide Readmissions Database is a nationally representative dataset comprising 49% of US hospitalizations in 2013. In this retrospective cohort study, we used ICD-9-CM codes to identify medical conditions. Index admissions for epilepsy (n = 58,278) were compared against index admissions for stroke (n = 215,821) and common medical causes (n = 973,078). Readmission rates (per 100,000 index admissions) for depression or bipolar disorders within 90 days from discharge for index hospitalization were calculated. Cox regression was used to test for associations between admission type (defined in 3 categories as above) and readmission for depression or bipolar disorder up to 1 year after index admission, in univariate models and adjusted for age, sex, psychiatric history, drug abuse, income quartile of patient's zip code, and index hospitalization characteristics.ResultsThe adjusted hazard ratio (HR) for readmission for depression in the epilepsy group was elevated at 2.80 compared to the stroke group (95% confidence interval [CI] 2.39–3.27, p < 2 × 10−16), and 2.09 compared to the medical group (95% CI 1.88–2.32, p < 2 × 10−16). The adjusted HR for readmission for bipolar disorder in the epilepsy group was elevated at 5.84 compared to the stroke group (95% CI 4.56–7.48, p < 2 × 10−16), and 2.46 compared to the medical group (95% CI 2.16–2.81, p < 2 × 10−16).ConclusionAdmission for epilepsy was independently associated with subsequent hospital readmission for mood disorders. The magnitude of elevated risk in this population suggests that patients admitted with epilepsy may warrant targeted psychiatric screening during their hospital admission.

scholarly journals Schizophrenia and suicide: Systematic review of risk factors

2005 ◽  
Vol 187 (1) ◽  
pp. 9-20 ◽  
Author(s):  
Keith Hawton ◽  
Lesley Sutton ◽  
Camilla Haw ◽  
Julia Sinclair ◽  
Jonathan J. Deeks
Keyword(s):  
Risk Factors ◽  
Suicide Risk ◽  
Depressive Disorders ◽  
Suicide Attempts ◽  
Drug Misuse ◽  
Adherence To Treatment ◽  
Affective Symptoms ◽  
Increased Risk ◽  
Motor Restlessness ◽  
Robust Evidence

BackgroundSuicide risk is greatly increased in schizophrenia. Detection of those at risk is clinically important.AimsTo identify risk factors for suicide in schizophrenia.MethodThe international literature on case-control and cohort studies of patients with schizophrenia or related conditions in which suicide was reported as an outcome was systematically reviewed. Studies were identified through searching electronic databases and reference lists, and by consulting experts.ResultsTwenty-nine eligible studies were identified. Factors with robust evidence of increased risk of suicide were previous depressive disorders (OR=3.03, 95% CI 2.06–4.46), previous suicide attempts (OR=4.09, 95% CI 2.79–6.01), drug misuse (OR=3.21, 95% CI 1.99–5.17), agitation or motor restlessness (OR=2.61, 95% CI 1.54–4.41), fear of mental disintegration (OR=12.1, 95% CI 1.89–81.3), poor adherence to treatment (OR=3.75, 95% CI 2.20–6.37) and recent loss (OR=4.03, 95% CI 1.37–11.8). Reduced risk was associated with hallucinations (OR=0.50, 95% CI 0.35–0.71).ConclusionsPrevention of suicide in schizophrenia is likely to result from treatment of affective symptoms, improving adherence to treatment, and maintaining special vigilance in patients with risk factors, especially after losses.

scholarly journals Untreated Insomnia in Corrections and Increased Risk of Death

CNS Spectrums ◽  
2021 ◽  
Vol 26 (2) ◽  
pp. 177-177
Author(s):  
Caiti Collins ◽  
Richard Wallis
Keyword(s):  
Health Outcomes ◽  
Sleep Problems ◽  
Negative Consequences ◽  
Correctional Setting ◽  
Quality Healthcare ◽  
Risk Of Death ◽  
Increased Risk ◽  
Common Practices ◽  
Correctional Settings ◽  
Negative Health Outcomes

AbstractStudy ObjectivesThis review discusses the potential negative consequences of untreated insomnia in correctional settings.MethodsA literature review was conducted on the association between insomnia and negative health outcomes, the best practices for treating insomnia with and without medications, and common practices that prohibit the treatment of insomnia in correctional settings.ResultsUntreated insomnia was associated with increased psychiatric distress, increased risk for suicide, and increased all-cause mortality. Common practices in many correctional institutions impose restrictions on treating insomnia. These practices lead to an increased likelihood for negative health outcomes, including suicide and an increase in all-cause death.ConclusionsPractices that prohibit the treatment of sleep in correctional settings increase the risk of death by suicide and other adverse health outcomes. The practices are often put in place due to pressure from the security staff who have trouble controlling the black-market trade of prescribed medications and other contraband within jails and prisons. Healthcare professionals in the correctional setting must advocate for the importance of treating sleep problems in jails and prisons and work with security staff on ways to overcome the problems of pill diversion and the trade of contraband in order to provide quality healthcare to this protected population.

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