Recovery and its correlates among patients with bipolar disorder: A study from a tertiary care centre in North India

2016 ◽  
Vol 62 (8) ◽  
pp. 726-736 ◽  
Author(s):  
Sandeep Grover ◽  
Nandita Hazari ◽  
Jitender Aneja ◽  
Subho Chakrabarti ◽  
Sunil Sharma ◽  
...  

Background and Aim: The goal of treatment in mental illness has evolved from a symptom-based approach to a personal recovery–based approach. The aim of this study was to evaluate the predictors of personal recovery among patients with bipolar disorder. Methodology: A total of 185 patients with bipolar disorder, currently in remission, were evaluated on Recovery Assessment Scale (RAS), Internalized Stigma of Mental Illness Scale (ISMIS), Brief Religious coping scale (RCOPE), Duke University Religiosity Index (DUREL), Religiousness Measures Scale, Hamilton depression rating scale (HDRS), Young Mania rating scale (YMRS) and Global Assessment of Functioning (GAF) scale. Results: The mean age of the sample was 40.5 (standard deviation (SD), 11.26) years. Majority of the participants were male, married, working, Hindu by religion and belonged to extended/joint families of urban background. In the regression analysis, RAS scores were predicted significantly by discrimination experience, stereotype endorsement and alienation domains of ISMIS, level of functioning as assessed by GAF, residual depressive symptoms as assessed by HDRS and occupational status. The level of variance explained for total RAS score and various RAS domains ranged from 36.2% to 46.9%. Conclusion: This study suggests that personal recovery among patients with bipolar disorder is affected by stigma, level of functioning, residual depressive symptoms and employment status of patients with bipolar disorder.

2016 ◽  
Vol 33 (S1) ◽  
pp. s236-s237
Author(s):  
W.M. Bahk ◽  
M.D. Kim ◽  
Y.E. Jung ◽  
Y.S. Woo ◽  
J. Lee ◽  
...  

ObjectivesThe Bipolar Depression Rating Scale (BDRS) is a scale for assessment of the clinical characteristics of bipolar depression. The primary aims of this study were to describe the development of the Korean version of the BDRS (K-BDRS) and to establish more firmly its psychometric properties in terms of reliability and validity.MethodsThe study included 141 patients (62 male and 79 female) who had been diagnosed with bipolar disorder, were currently experiencing symptoms of depression, and were interviewed using the K-BDRS. Other measures included the Montgomery and Asberg Depression Scale (MADRS), the 17-item Hamilton Depression Scale (HAMD), and the Young Mania Rating Scale (YMRS). Additionally, the internal consistency, concurrent validity, inter-rater reliability, and test-retest reliability of the K-BDRS were evaluated.ResultsThe Cronbach's α-coefficient for the K-BDRS was 0.866, the K-BDRS exhibited strong correlations with the HAMD (r = 0.788) and MADRS (r = 0.877), and the mixed symptoms score of the K-BDRS was significantly correlated with the YMRS (r = 0.611). An exploratory factor analysis revealed three factors that corresponded to psychological depressive symptoms, somatic depressive symptoms, and mixed symptoms.ConclusionsThe present findings suggest that the K-BDRS has good psychometric properties and is a valid and reliable tool for assessing depressive symptoms in patients with bipolar disorder.Disclosure of interestThe authors have not supplied their declaration of competing interest.


2020 ◽  
Vol 9 (2) ◽  
pp. 1-6
Author(s):  
Ankit Awasthi ◽  
Arpit Koolwal ◽  
Nikita Dhaka ◽  
Ghanshyam Das Koolwal ◽  
Sanjay Gehlot

Background: Cognitive dysfunction is an established entity in bipolar disorder. The affected individuals exhibit wide-ranging deficits involving multiple domains of cognitive functioning. These deficits are associated with poor functional outcome and residual disability in patients. A substantial literature exists globally on cognition in bipolar disorder; however, few studies have been carried out on this subject in India and    in Rajasthan. The aim of the study is to compare cognitive functions of bipolar disorder patients and healthy control subjects. Subjects and Methods: This cross-sectional study was conducted at the Psychiatry department of a tertiary care institution on 50 bipolar disorder patients and matched healthy controls subjects who fulfilled the inclusion criteria. The diagnosis was made by DSM-V criteria, and symptom severity was determined by the Young Mania Rating Scale (YMRS) and the Hamilton Depression Rating Scale (HAM-D). After seeking socio-demographic details, all participants were administered the Post Graduate Institute Battery of Brain Dysfunction (PGI-BBD) to assess cognitive functioning. Data collected were subjected to suitable statistical analysis (mean, standard deviation, and chi-square test). Results: The majority of the bipolar disorder patients (54%) were under 35 years of age, were males (60%), were from the urban background (70%), and were married (82%). Bipolar disorder patients performed poorly on all domains of cognitive functioning, i.e. memory, performance and verbal intelligence, and perceptuo-motor skills. Conclusion: The present study affirmed the previous findings of wide-spread cognitive impairment in bipolar disorder patients. Prompt diagnosis and treatment are the key steps to reduce the cognitive morbidity associated with this disorder.


Author(s):  
Poonam Bharti ◽  
Bimal Kumar Agrawal ◽  
Parul Gupta ◽  
Mohit Singla ◽  
LN Garg ◽  
...  

Introduction: Coronavirus Disease (COVID-19) outbreak is one of the biggest medical challenges to humankind in recent times, started from China in December 2019, and had spread to almost all the countries of the world. The social, psychological and economic fissures exposed by the pandemic resulted in mass disruption in human behaviour population. This is pushing them towards more stress. Aim: To analyse the anxiety and depressive symptoms in COVID-19 positive patients. Materials and Methods: A cross-sectional study was conducted on 325 COVID positive patients who were admitted in isolation ward in Tertiary Care Centre and were enrolled in this study, out of which 18 subjects refused to give the consent and 5 were already taking psychiatric medications and were excluded. Telephonic contact was not established with rest of the 5 patients. After ethical clearance, the anxiety and depressive symptoms were assessed by using Hamilton Anxiety Rating Scale (HAM-A) and Hamilton Depression Rating Scale (HAM-D). Results: Maximum patients belonged to age group of 21-40 years (54.9%). Maximum patients were males (70%). Almost 3/4th of the population 64% had depressive symptoms of different severity and 61% had anxiety symptoms. Significant association of anxiety symptoms was seen with gender (p=0.001) and marital status (p=0.002). No association with depressive symptoms was seen with gender (p=0.087) and marital status (p=0.399). Conclusion: COVID-19 had significant impact on the patients. More than half of the population had showed the psychological issues in the form of anxiety and depression. Males and married patients were affected more with both anxiety and depressive symptoms.


2003 ◽  
Vol 48 (1) ◽  
pp. 52-55 ◽  
Author(s):  
J Rajeev ◽  
Shoba Srinath ◽  
YCJ Reddy ◽  
MG Shashikiran ◽  
Satish Chandra Girimaji ◽  
...  

Objective: Recent studies of patients with juvenile bipolar disorder report low rates of recovery and high rates of chronicity. However, we lack data on the short-term outcome. This study examines the pattern of recovery from the index episode in an aggressively treated juvenile sample. Method: We assessed 25 subjects (< 16 years) with a diagnosis of mania, using the Diagnostic Interview for Children and Adolescents-Revised) (DICA-R), Young Mania Rating Scale (YMRS), and Children's Global Assessment Scale (CGAS) at intake and at 3 and 6 months. We studied the time taken to recover from the index episode, the level of functioning, and the factors predicting them. Results: After 6 months, 24 (96%) subjects had recovered from the index manic episode. The median time to recovery was 27 days. Total episode length was significantly longer among those with previous affective episodes. Conclusions: The findings suggest that juvenile-onset mania has high rates of recovery and low rates of chronicity. These differences from the existing literature need further exploration.


Author(s):  
Vineet Sharma ◽  
Sunny Garg ◽  
Dinesh D. Sharma ◽  
Alka Chauhan ◽  
Milli Sharma

Background: Bipolar disorder is the sixth leading cause of disability worldwide and has a lifetime prevalence of about 3% in general population. In patients with bipolar disorder there was 58 % lifetime prevalence of co-occurring alcohol abuse and a 38 % lifetime prevalence of co-occurring other substance abuse. Substance abuse interferes with treatment and management approaches of the bipolar disorder.Methods: A cross sectional observational study of 120 male patients divided in substance abusing (60) and non-substance abusing groups (60) with bipolar disorder according to DSM-V, who met the Inclusion criteria . A written informed consent was obtained from the patients and/ or their family members. Patient’s information was recorded on the socio-demographic and clinical profile sheet .Thereafter, YMRS or HAM-D scales were applied as per the phase of the illness.Results: Most of the patients were between 15-25 years in SAB group and 35-50 years in NSAB group, educated, semiskilled and married. Tobacco abuse was the commonest followed by cannabis and alcohol abuse. The mean duration of hospital stay in SAB group was 41.40 days and in NSAB group was 43.20 days. Dysphoric mania, aggressive behavior and suicidal attempts were more in SAB group. Mean total YMRS score of SAB group was greater than NSAB group.Conclusions: Maximum patients had onset of substance abuse before the onset of affective symptoms. Manic symptomatology was more severe in substance abusing group.


JMS SKIMS ◽  
2020 ◽  
Vol 23 (1) ◽  
pp. 48-49
Author(s):  
Javaid Ahmad Bhat ◽  
Shariq Rashid Masoodi

Apropos to the article by Dr Bali, titled “Mupirocin resistance in clinical isolates of methicillin-sensitive and resistant Staphylococcus aureus in a tertiary care centre of North India” (1), the authors have raised important issue of emerging antimicrobial resistance (AMR). Antimicrobial resistance is an increasingly serious threat to global public health that requires action across all government sectors and society. As per WHO, AMR lurks the effective prevention and management of an ever-increasing spectrum of infections caused by bacteria, parasites, fungi and viruses. Novel resistance mechanisms are emerging and spreading globally, threatening the man’s ability to treat common infectious diseases.


2017 ◽  
Vol 41 (S1) ◽  
pp. s779-s779
Author(s):  
L. Mehl-Madrona ◽  
B. Mainguy

IntroductionThere is ongoing debate about about both the value of psychotherapy in psychotic disorders and the best type of psychotherapy to use if necessary.MethodsWe conducted narrative psychotherapy with 18 adults, all diagnosed as having bipolar disorder with psychotic features and/or schizo-affective disorder. Outcome data consisted of the Positive and Negative Symptom Scale, the Clinical Global Impressions Scale, the Young Mania Rating Scale, the Hamilton Anxiety and Depression Scales, the My Medical Outcome Profile, Version 2(MYMOP2), and the Outcome Rating Scales of Duncan and Miller. We compare the outcomes of our patients to those of a matched comparison group receiving conventional psycho-education and cognitive behavioural therapy. Patients were seen for a minimum of 16 weeks over an average of 22 weeks. Average age was 31.5 years with a standard deviation of 8.1 years.ResultsThe narrative therapy group showed statistically significant reductions in all outcome measures compared to the conventional treatment group. They continued treatment significantly longer and had fewer re-hospitalizations. They were less distressed by voices.ConclusionsA narrative psychotherapy approach using dialogical theory and therapy ideas is a reasonable approach for the psychotherapy of psychosis. Review of psychotherapy notes showed that narrative approaches allowed the therapist to align with the patient as collaborator in considering the story presented and was therefore less productive of defensiveness and self-criticism than conventional approaches. The therapy included techniques for negotiating changes in illness narratives, identity narratives, and treatment narratives that were more conducive of well-being and recovery.Disclosure of interestThe authors have not supplied their declaration of competing interest.


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