Functional impairment and previous suicide attempts in bipolar disorder

2008 ◽  
Vol 20 (6) ◽  
pp. 300-306 ◽  
Author(s):  
Adriane R. Rosa ◽  
Carolina Franco ◽  
Anabel Martínez-Aran ◽  
Jose Sánchez-Moreno ◽  
Manel Salamero ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Family History ◽  
Functional Impairment ◽  
Degrees Of Freedom ◽  
Suicide Attempts ◽  
Structured Interview ◽  
Psychotic Symptoms ◽  
History Of ◽  
Dsm Iv ◽  
Bipolar Patients

Objective:The aim of the present study was to assess the association between previous suicide attempts and functional impairment among euthymic patients with bipolar disorder (BD).Methods:Seventy-one Diagnostic Statistical Manual IV (DSM-IV) patients with BD and 61 healthy volunteers were recruited from the Bipolar Disorder Program at the Clinic Hospital of Barcelona. Patients with (n = 36, 50.7%) and without (n = 35, 49.3%) previous suicide attempts were assessed using the Structured Clinical Interview for DSM-IV-TR (SCID-P). Previous suicide attempts were carefully investigated by means of patient and caregiver interview and by a standard structured interview from the protocol of our BD Program. The Functioning Assessment Short Test (FAST) was employed to assess functional impairment.Results:Euthymic patients with previous suicide attempts showed functional impairment, particularly in occupational (F = 30.39; p = 0.001) and cognitive functioning (F = 18.43; p = 0.001). In addition, family history of psychiatric illness (χ2: 6.49; degrees of freedom (df) = 2;132; p = 0.010), family history of affective disorders (χ2 = 5.57; p = 0.017), psychotic symptoms (χ2 = 5.88; p = 0.014) and axis II comorbidity were associated with previous suicide attempts (χ2 = 5.16; p = 0.021).Conclusion:Bipolar patients with previous suicide attempts had lower overall functioning than patients who did not attempt suicide. Previous suicide attempts were particularly associated with the occupational and cognitive domains of functioning.

First Clinical Signs of the Bipolar Prodrome

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
G. Juckel
Keyword(s):  
Bipolar Disorder ◽  
Family History ◽  
Positive Family History ◽  
Clinical Signs ◽  
Structured Interview ◽  
Psychotic Episode ◽  
Affective Temperament ◽  
History Of ◽  
Bipolar Patients

Temperament and mood swings are promising indicator for the characterization of mood-spectrum vulnerability. The aim of this study was to investigate the relationship between affective temperament and mood swings in bipolar disorder. We explored these clinical features retrospectively. Patients who met the criteria for Bipolar I disorder were enrolled in the study. Exclusion criteria were partial remittance and a full affective or psychotic episode. Data concerning illness and family history, mood swings (semi-structured interview) and depression (BDI) were obtained. We examined premorbid temperament with TEMPS-A, and with the validated German version TEMPS-M. Patients with and without mood swings were compared with respect to the dominant temperament. Out of 20 bipolar patients, 6 subjects reported mood swings prior to the onset of affective disorder. Subjects with mood swings significantly correlated with a positive family history of affective disorders. Concerning cyclothymic, irritable, and hyperthymic temperament, bipolar affective patients with mood swings had higher scores. No differences were found between males and females. Our findings support the assumption that mood swings, as represented by the cyclothymic temperament, could be prodromes of bipolar disorder. These traits may represent vulnerability markers and could presumably be used to identify individuals at high risk for developing bipolar disorder in order to prevent this illness or to modify its course. A further retrospective study with a larger sample size was started to deepen knowledge about putative prodromal symptoms of bipolar disorder.

Obesity is associated with previous suicide attempts in bipolar disorder

2010 ◽  
Vol 22 (2) ◽  
pp. 63-67 ◽  
Author(s):  
Fabiano A. Gomes ◽  
Márcia Kauer-Sant’Anna ◽  
Pedro V. Magalhães ◽  
Felice N. Jacka ◽  
Seetal Dodd ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Suicide Attempt ◽  
Suicide Attempts ◽  
University Hospital ◽  
Comprehensive Management ◽  
History Of ◽  
Axis I ◽  
Dsm Iv ◽  
Bipolar Patients ◽  
The University

Gomes FA, Kauer-Sant’Anna M, Magalhães PV, Jacka FN, Dodd S, Gama CS, Cunha Â, Berk M, Kapczinski F. Obesity is associated with previous suicide attempts in bipolar disorder.Objective:There is a paucity of data about risk factors for suicide attempts in bipolar disorder. The aim of this study is to examine the association between suicide attempts and obesity in people with bipolar disorder.Methods:Two hundred fifty-five DSM-IV out-patients with bipolar disorder were consecutively recruited from the Bipolar Disorder Program at Hospital das Clínicas de Porto Alegre and the University Hospital at the Universidade Federal de Santa Maria, Brazil. Diagnosis and clinical variables were assessed with Structured Clinical Interview for DSM-IV-axis I (SCID I) and Program structured protocol. History of suicide attempts was obtained from multiple information sources including patients, relatives and review of medical records. Patients with body mass index (BMI) ≥ 30 were classified as obese.Results:Over 30% of the sample was obese and over 50% had a history of suicide attempt. In the multivariate model, obese patients were nearly twice (OR = 1.97, 95% CI: 1.06–3.69, p = 0.03) as likely to have a history of suicide attempt(s).Conclusion:Our results emphasise the relevance of obesity as an associated factor of suicide attempts in bipolar disorder. Obesity may be seen as correlate of severity and as such, must be considered in the comprehensive management of bipolar patients.

Baseline and prodromal characteristics of first- versus multiple-episode mania in a French cohort of bipolar patients

2011 ◽  
Vol 27 (8) ◽  
pp. 557-562 ◽  
Author(s):  
J.-M. Azorin ◽  
A. Kaladjian ◽  
M. Adida ◽  
E. Fakra ◽  
E. Hantouche ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Suicide Attempts ◽  
Correct Diagnosis ◽  
Manic Episode ◽  
Psychotic Symptoms ◽  
First Episode ◽  
Prodromal Phase ◽  
Multiple Episode ◽  
Patients At Risk ◽  
Bipolar Patients

AbstractObjective:To identify some of the main features of bipolar disorder for both first-episode (FE) mania and the preceding prodromal phase, in order to increase earlier recognition.Methods:One thousand and ninety manic patients (FE=81, multiple-episodes [ME]=1009) were assessed for clinical and temperamental characteristics.Results:Compared to ME, FE patients reported more psychotic and less depressive symptoms but were comparable with respect to temperamental measures and comorbid anxiety. The following independent variables were associated with FE mania: a shorter delay before correct diagnosis, greater substance use, being not divorced, greater stressors before current mania, a prior diagnosis of an anxiety disorder, lower levels of depression during index manic episode, and more suicide attempts in the past year.Conclusion:In FE patients, the diagnosis of mania may be overlooked, as they present with more psychotic symptoms than ME patients. The prodromal phase is characterised by high levels of stress, suicide attempts, anxiety disorders and alcohol or substance abuse. Data suggest to consider these prodromes as harmful consequences of temperamental predispositions to bipolar disorder that may concur to precipitate mania onset. Their occurrence should therefore incite clinicians to screen for the presence of such predispositions, in order to identify patients at risk of FE mania.

scholarly journals Dissecting clinical heterogeneity of bipolar disorder using multiple polygenic risk scores

2020 ◽  
Author(s):  
Brandon J. Coombes ◽  
Matej Markota ◽  
J. John Mann ◽  
Colin Colby ◽  
Eli Stahl ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Psychiatric Disorders ◽  
Suicide Attempts ◽  
Risk Scores ◽  
Rapid Cycling ◽  
Clinical Heterogeneity ◽  
Polygenic Risk ◽  
Clinical Observations ◽  
History Of ◽  
Dsm Iv

AbstractBipolar disorder (BD) has high clinical heterogeneity, frequent psychiatric comorbidities, and elevated suicide risk. To determine genetic differences between common clinical sub-phenotypes of BD, we performed a systematic PRS analysis using multiple polygenic risk scores (PRSs) from a range of psychiatric, personality, and lifestyle traits to dissect differences in BD sub-phenotypes in two BD cohorts: the Mayo Clinic BD Biobank (N = 968) and Genetic Association Information Network (N = 1001). Participants were assessed for history of psychosis, early-onset BD, rapid cycling (defined as four or more episodes in a year), and suicide attempts using questionnaires and the Structured Clinical Interview for DSM-IV. In a combined sample of 1969 bipolar cases (45.5% male), those with psychosis had higher PRS for SCZ (OR = 1.3 per S.D.; p = 3e-5) but lower PRSs for anhedonia (OR = 0.87; p = 0.003) and BMI (OR = 0.87; p = 0.003). Rapid cycling cases had higher PRS for ADHD (OR = 1.23; p = 7e-5) and MDD (OR = 1.23; p = 4e-5) and lower BD PRS (OR = 0.8; p = 0.004). Cases with a suicide attempt had higher PRS for MDD (OR = 1.26; p = 1e-6) and anhedonia (OR = 1.22; p = 2e-5) as well as lower PRS for educational attainment (OR = 0.87; p = 0.003). The observed novel PRS associations with sub-phenotypes align with clinical observations such as rapid cycling BD patients having a greater lifetime prevalence of ADHD. Our findings confirm that genetic heterogeneity underlies the clinical heterogeneity of BD and consideration of genetic contribution to psychopathologic components of psychiatric disorders may improve genetic prediction of complex psychiatric disorders.

Psychotic symptoms in pediatric bipolar disorder and family history of psychiatric illness

2006 ◽  
Vol 96 (1-2) ◽  
pp. 127-131 ◽  
Author(s):  
Richard Rende ◽  
Boris Birmaher ◽  
David Axelson ◽  
Michael Strober ◽  
Mary Kay Gill ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Family History ◽  
Psychiatric Illness ◽  
Psychotic Symptoms ◽  
Pediatric Bipolar Disorder ◽  
History Of

Postpartum Psychosis

2020 ◽  
pp. 39-50
Author(s):  
Nikole Benders-Hadi
Keyword(s):  
Bipolar Disorder ◽  
Family History ◽  
Elevated Risk ◽  
Psychotic Symptoms ◽  
Postpartum Psychosis ◽  
Poor Sleep ◽  
Activity Levels ◽  
History Of ◽  
Infant Hospitalization ◽  
Increased Activity

This chapter on postpartum psychosis notes that the risk of postpartum psychosis in the general population is very rare at less than 1%. In a mother with a known history of schizophrenia, this risk increases to 25%. Psychotic symptoms appearing postpartum may also be evidence of a bipolar disorder. The presence of elevated mood, increased activity levels and energy, poor sleep, and a family history of manic episodes all increase the likelihood that a bipolar disorder is present. Women with a personal or family history of a bipolar disorder are at an elevated risk of developing a mania or depression with psychotic symptoms postpartum. Postpartum psychosis due to any cause is a psychiatric emergency and treatment should be initiated early and aggressively to ensure the safety of mother and infant. Hospitalization and/or separation of the baby and mother may be necessary. The use of medication to treat schizophrenia or bipolar disorder during pregnancy may decrease the risk of a postpartum psychosis. With appropriate postpartum medication and support, the majority of women experiencing postpartum psychosis recover well and the risk of recurrent psychotic symptoms can be greatly reduced.

Clinical Factors as Predictors on Functional Impairment in Bipolar Disorder

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
A. Rosa ◽  
M. Reinares ◽  
C. Franco ◽  
M. Comes ◽  
C. Torrent ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Depressive Symptoms ◽  
Interpersonal Relationships ◽  
Functional Impairment ◽  
Severe Illness ◽  
Clinical Factors ◽  
Short Test ◽  
Dsm Iv ◽  
Bipolar Patients ◽  
Financial Issues

Introduction:Recent studies have suggested that functional impairment in bipolar disorder may be strongly associated with residual depressive symptoms. However, there is a notable disparity between functional recovery and symptomatic recovery. This study was carried out to investigate clinical factors as potential predictors on functional impairment in a well defined euthymic bipolar sample.Methods:Seventy-one patients were recruited from the Bipolar Disorder Program at the Clinic Hospital of Barcelona. A Structured Clinical Interview for DSM-IV-TR, HAM-D and YMRS were used to diagnostic assessment and euthymia criteria. The Functioning Assessment Short Test (FAST) was employed to assess functional impairment. The FAST is a reliable and valid, interview-administered scale, rapid and easy to apply (3-6 min). It consists of 24 items which allow to assess six specific areas of functioning such as autonomy, occupational functioning, cognitive functioning, financial issues, interpersonal relationships, and leisure time.Results:The sample comprised 36 (51%) men, aged 48±13.56 years. Several clinical variables were associated with poor functioning on a linear regression model, such as age, depressive symptoms, number of previous mixed episodes and number of previous hospitalizations. This model explained 44% of the variance (F=12.54, df=58, p< 0.001).Discussion:In this study, specific clinical and socio-demographic characteristics were identified as predictors of functional impairment in remitted bipolar patients. Poor functioning was identified in patients with older age and more severe illness course.

Bipolar versus schizoaffective disorder: Clinical profiles

2017 ◽  
Vol 41 (S1) ◽  
pp. S426-S427
Author(s):  
A.M. Romosan ◽  
L. Dehelean ◽  
R.S. Romosan ◽  
I. Papava ◽  
I. Drut
Keyword(s):  
Family History ◽  
Schizoaffective Disorder ◽  
Demographic Characteristics ◽  
Psychotic Symptoms ◽  
Psychiatric Clinic ◽  
Onset Age ◽  
Two Samples ◽  
History Of ◽  
Clinical Profiles ◽  
Bipolar Patients

IntroductionDifferentiating between bipolar (BD) and schizoaffective disorder (SAD) can be challenging, especially during early stages of the illness.ObjectivesComparing clinical profiles and socio-demographic characteristics of patients diagnosed with BD and SAD.MethodsThe study, conducted between 2014–2016, included 67 inpatients from the Timisoara Psychiatric Clinic, diagnosed with either BD (n = 35) or SAD (n = 32), according to ICD-10 criteria. The following parameters were analyzed: number of episodes, number of times hospitalized, onset age, frequency and nature of psychotic symptoms, family history of psychiatric disorders and socio-demographic characteristics (age, sex, marital status). Data were obtained by direct interview and patient files. Symptom severity was measured with Brief Psychiatric Rating Scale (BPRS).ResultsThere were no significant differences between the two samples regarding age or sex distribution. Schizoaffective patients were more frequent unmarried (P = 0.007). Onset age was significantly lower in SAD patients (22.41 years for SAD, 28.36 years for BD). SAD patients had the highest number of episodes and needed more frequent hospitalization. Bipolar patients had higher percentage of family history of affective disorders when compared to schizoaffective patients (41% versus 36%). Hallucinations were more frequently found in schizoaffective patients than in bipolar patients (P = 0.004). We found no significant differences between the two samples regarding the presence or the type of delusions. The SAD sample had significantly higher BPRS total scores than bipolar patients (P = 0.035).ConclusionsAlthough this study revealed numerous similarities between BD and SAD, it also identified differences that may be helpful in establishing the correct diagnosis.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Comorbid medical illness in bipolar disorder

2014 ◽  
Vol 205 (6) ◽  
pp. 465-472 ◽  
Author(s):  
Liz Forty ◽  
Anna Ulanova ◽  
Lisa Jones ◽  
Ian Jones ◽  
Katherine Gordon-Smith ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Suicide Attempts ◽  
Mental Health Disorder ◽  
Acute Onset ◽  
Medical Illness ◽  
Illness Burden ◽  
Increased Risk ◽  
History Of ◽  
Dsm Iv ◽  
The Uk

BackgroundIndividuals with a mental health disorder appear to be at increased risk of medical illness.AimsTo examine rates of medical illnesses in patients with bipolar disorder (n = 1720) and to examine the clinical course of the bipolar illness according to lifetime medical illness burden.MethodParticipants recruited within the UK were asked about the lifetime occurrence of 20 medical illnesses, interviewed using the Schedules for Clinical Assessment in Neuropsychiatry (SCAN) and diagnosed according to DSM-IV criteria.ResultsWe found significantly increased rates of several medical illnesses in our bipolar sample. A high medical illness burden was associated with a history of anxiety disorder, rapid cycling mood episodes, suicide attempts and mood episodes with a typically acute onset.ConclusionsBipolar disorder is associated with high rates of medical illness. This comorbidity needs to be taken into account by services in order to improve outcomes for patients with bipolar disorder and also in research investigating the aetiology of affective disorder where shared biological pathways may play a role.Declarations of interestNone.

The Relationship Between Childhood Abuse and Suicidality in Adult Bipolar Disorder

2008 ◽  
Vol 23 (3) ◽  
pp. 361-372 ◽  
Author(s):  
Roger S. McIntyre ◽  
Joanna K. Soczynska ◽  
Deborah Mancini ◽  
Chris Lam ◽  
Hanna O. Woldeyohannes ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Childhood Abuse ◽  
Childhood Maltreatment ◽  
Suicide Attempts ◽  
Retrospective Chart Review ◽  
Management Planning ◽  
History Of Childhood ◽  
University Of Toronto ◽  
History Of ◽  
Bipolar Patients

This study evaluates the effect of childhood sexual and physical abuse on suicidality in adults with bipolar disorder. We conducted a retrospective chart review of adult outpatients (N = 381) with DSM-IV-TR–defined bipolar disorder seeking evaluation and treatment at an academic specialty research program (i.e., Mood Disorders Pharmacology Unit, University Health Network, University of Toronto) between October 2002 and November 2005. Eighteen percent (n = 68) of adult patients with bipolar disorder had a recorded history of childhood abuse (p = 0.009). Sixty-three percent (n = 43) of bipolar patients with a history of childhood abuse reported lifetime suicidality (χ2 = 6.885, df = 1, p = 0.009). Logistic regression analysis indicated that Childhood abuse was a significant predictor of lifetime suicidality in adult bipolar patients (OR = 2.05, CI = 1.19–3.510). Childhood abuse is associated with suicidal ideation and suicide attempts in adults with bipolar disorder. Anamnestic inquiry regarding childhood maltreatment is salient to risk assessment, illness management planning, preventative strategies, and treatment interventions in bipolar disorder.

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